MEDICARE: DR. CONSTANCE M JUDGE MD

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	208000000X	Pediatrics Physician	35066650J	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	144118001	OTHER	OH	CIGNA
2	341106740033	OTHER	OH	CARESOURCE
3	000000127389	OTHER	OH	ANTHEM
4	R66650	OTHER	OH	SUMMA CARE
5	1385893	OTHER	OH	UNITED HEALTHCARE
6	5479089	OTHER	OH	AETNA
7	54514	OTHER	OH	QUAL CHOICE
8	71303	OTHER	OH	NATIONWIDE HEALTH PLANS

General Provider Information

NPI Number	:	1851398291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CONSTANCE M JUDGE MD

Provider Business Mailing Address
First Line	:	35010 CHARDON RD
Second Line	:	SUITE 205
City	:	WILLOUGHBY
State	:	OH
Zip	:	44094-9010
Country	:	US
Telephone Number	:	440-918-0501
Fax Number	:	440-918-0525

Provider Business Practice Location Address
First Line	:	35010 CHARDON RD
Second Line	:	SUITE 205
City	:	WILLOUGHBY
State	:	OH
Zip	:	44094-9010
Country	:	US
Telephone Number	:	440-918-0501
Fax Number	:	440-918-0525

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	11/20/2020

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Directions to “ DR. CONSTANCE M JUDGE MD” Practice Location

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