Healthcare Provider Details

I. General information

NPI: 1407842115
Provider Name (Legal Business Name): CHIEDOZIE I UDEH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 08/05/2023
Certification Date: 08/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE J5-624
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE J5-624
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-2781
  • Fax:
Mailing address:
  • Phone: 216-444-2781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35614
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number35614
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number35614
License Number StateIA
# 4
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number35.097102
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35.097102
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: