Individual
DR. JEROME SUDE
Active
Individual
DR. JEROME SUDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3046/T812
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000134329
ANTHEM
OH
05
—
0505046
—
OH
01
—
0655759
AETNA HMO
OH
01
—
1418274
UNITED HEALTHCARE
OH
01
—
341572960B
SUMMA
OH
01
—
410022025
RAILROAD MEDICARE
OH
01
—
4338408
AETNA PPO
OH
01
—
728946
BUCKEYE
OH
Enumeration date
05/24/2005
Last updated
06/08/2021
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