Healthcare Provider Details

I. General information

NPI: 1184923351
Provider Name (Legal Business Name): SUSAN DUDDY MARTIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2011
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-5000
  • Fax: 216-445-3692
Mailing address:
  • Phone: 216-445-5000
  • Fax: 216-445-3692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number35.156746
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: