Healthcare Provider Details

I. General information

NPI: 1598829608
Provider Name (Legal Business Name): MICHELLE LYNN CUDNIK PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 ARCH ST SUITE 1B
AKRON OH
44304-1423
US

IV. Provider business mailing address

2032 HUDSON DR
CANAL FULTON OH
44614-8452
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-3602
  • Fax:
Mailing address:
  • Phone: 330-854-0374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-2-23089
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: