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General NPI Number Information
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NPI Number | 1518921014
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Entity Type | Individual
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Provider Name | CHRISTIAN P DUDENHOEFER MD
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Gender | Male
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 12/23/2019
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Provider Practice Location Address
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Address Line | 1101 PENINSULA DR STE 202
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City | ERIE
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State | PA
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Zip | 16505-4169
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Country | US
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Telephone | 814-833-5381
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Fax | 814-833-5387
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Provider Business Mailing Address
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Address Line | 2059 W 8TH ST
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City | ERIE
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State | PA
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Zip | 16505-4741
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Country | US
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Telephone | 814-459-6777
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Fax | 814-459-6367
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD043235L
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License Number State | PA
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