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NPI Code Detail

MEDICARE: STEFAN GUDZ PA-C

MEDICARE: STEFAN GUDZ PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant50.006549RXOH

General Provider Information

NPI Number : 1578178323
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEFAN GUDZ PA-C
Provider Business Mailing Address
First Line : 3101 W US HIGHWAY 224
Second Line :
City : TIFFIN
State : OH
Zip : 44883-8305
Country : US
Telephone Number : 419-448-0220
Fax Number :
Provider Business Practice Location Address
First Line : 3569 RIDGE RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-5443
Country : US
Telephone Number : 216-281-0872
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2020
Last Update Date : 02/16/2026

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Directions to “ STEFAN GUDZ PA-C” Practice Location

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