Healthcare Provider Details

I. General information

NPI: 1881094142
Provider Name (Legal Business Name): DAVID FRANCOIS-XAVIER DUFRESNE M.D., FRCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2014
Last Update Date: 08/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE EPILEPSY CENTER
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

3337 E SCARBOROUGH RD
CLEVELAND HEIGHTS OH
44118-3410
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-9818
  • Fax:
Mailing address:
  • Phone: 216-333-6646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number2028712
License Number StateZZ
# 2
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number57.024022
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: