Healthcare Provider Details

I. General information

NPI: 1518844661
Provider Name (Legal Business Name): DAVID A HULLUM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2025
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 E 124TH ST
CLEVELAND OH
44108-1749
US

IV. Provider business mailing address

423 E 124TH ST
CLEVELAND OH
44108-1749
US

V. Phone/Fax

Practice location:
  • Phone: 330-572-9411
  • Fax:
Mailing address:
  • Phone: 330-572-9411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: