Healthcare Provider Details

I. General information

NPI: 1275502213
Provider Name (Legal Business Name): MICHAEL D CAUDY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3310 MERCY HEALTH BLVD STE 210
CINCINNATI OH
45211-1120
US

IV. Provider business mailing address

30 W RAMPART ST STE 200
SHELBYVILLE IN
46176-8846
US

V. Phone/Fax

Practice location:
  • Phone: 513-981-4300
  • Fax: 513-741-1416
Mailing address:
  • Phone: 317-421-2012
  • Fax: 317-398-1851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01054873A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: