Individual
PATRICK DANIEL ENDERS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6009 LANDERHAVEN DR, SUITE F, MAYFIELD HEIGHTS, OH 44124-4192
(440) 461-0042
Mailing address
6009 LANDERHAVEN DR, SUITE F, MAYFIELD HEIGHTS, OH 44124-4192
(440) 461-0042
(440) 461-5033
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35.039953
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000122911
ANTHEM BC/BS (FACET#)
—
05
—
0321842
—
OH
01
—
31-1685729026
CARE SOURCE (MEDICAID)
OH
01
—
31168572900
BUREAU OF WORKERS COMP
OH
01
—
311685729001
MEDICAL MUTUAL OF OH
OH
Enumeration date
07/13/2005
Last updated
07/08/2007
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