MEDICARE: DECLAN C MGBUDEM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	SS802996	OH

General Provider Information

NPI Number	:	1285442178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DECLAN C MGBUDEM

Provider Business Mailing Address
First Line	:	10449 TOWNLEY CT
Second Line	:
City	:	REMINDERVILLE
State	:	OH
Zip	:	44202-8152
Country	:	US
Telephone Number	:	234-389-2121
Fax Number	:

Provider Business Practice Location Address
First Line	:	17403 HARVARD AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-1715
Country	:	US
Telephone Number	:	234-389-2121
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/23/2024
Last Update Date	:	12/23/2024

Similar Medicare Providers

1457193732 — ONE STOP INTEGRATED HEALTHCARE CLINIC LLC
Practice Location Address:

17407 HARVARD RD , DOWN
CLEVELAND, OH
44128-1715

Practice Phone: 216-377-4719
Practice Fax: 216-200-8376

1710185889 — DR. BRENDA JO KOWALSKE M.D.
Practice Location Address:

1715 CLEVELAND HWY
GAINESVILLE, GA
30501-1357

Practice Phone: 404-276-7358
Practice Fax:

1205099520 — DR. YAZAN HADDADEEN DDS
Practice Location Address:

5716 BROADWAY AVE
CLEVELAND, OH
44127-1715

Practice Phone: 216-415-5504
Practice Fax:

1659616704 — ALAINA M PARDEE-MILLER LISW-S
Practice Location Address:

1212 HURON RD E
CLEVELAND, OH
44115-1715

Practice Phone: 216-619-6194
Practice Fax: 216-619-6195

1235507393 — DR. ANI PILIKYAN
Practice Location Address:

1715 CLEVELAND RD
GLENDALE, CA
91202-1011

Practice Phone: 818-720-6691
Practice Fax:

1639537616 — BROADWAY FAMILY DENTAL PRESENTED BY DR. TARIQ SAYEGH BDS LLC
Practice Location Address:

5716 BROADWAY AVENUE
CLEVELAND, OH
44127-1715

Practice Phone: 216-862-4990
Practice Fax: 216-862-3585

Directions to “ DECLAN C MGBUDEM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.