Individual
DR. HEIDI LYNELLE DUFF GULLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H.
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3944
Mailing address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3944
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
093903
OH
207Q00000X
Family Medicine Physician
41451
KY
207Q00000X
Family Medicine Physician
42890
TN
207Q00000X
Family Medicine Physician
MD27309
OR
2083P0901X
Public Health & General Preventive Medicine Physician
093903
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0297023
ADMINISTAR
KY
05
—
2980190
—
OH
01
—
3000971
CIGNA MEDICARE
TN
01
—
30009711
CIGNA MEDICARE
TN
01
—
35-093903
OHIO MEDICAL LICENSE
OH
01
—
41451
KY LIC
KY
01
—
42890
TN LICENSE
TN
01
—
MD27309
OREGON LICENSE
OR
01
—
P01013336
MEDICARE RAILROAD
OH
Enumeration date
12/04/2006
Last updated
03/07/2023
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