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Individual

DR. MOLLY S JUDGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
530 WASHINGTON ST, PORT CLINTON, OH 43452-1935
(419) 732-2618
(419) 732-1998
Mailing address
530 WASHINGTON ST, PORT CLINTON, OH 43452-1935
(419) 732-2618
(419) 732-1998

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
L834822
MI
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36.002877
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000142130
ANTHEM BCBS OH
OH
05
134887318
MI
05
2019774
OH
01
4855810540
BCBS MI
MI
Enumeration date
05/22/2006
Last updated
11/09/2012
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