Individual
JAMES EDWARD FUDURIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18697 BAGLEY RD, MIDDLEBURG HEIGHTS, OH 44130-3417
(440) 816-8000
Mailing address
21986 WOODFIELD TRL, STRONGSVILLE, OH 44149-9203
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
35038694
OH
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
35038694
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0521242
—
OH
01
—
942460636238
CARESOURCE
OH
Enumeration date
05/28/2006
Last updated
12/03/2012
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