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NPI Code Detail

MEDICARE: DENISE M. KUDER,O.D.

MEDICARE: DENISE M. KUDER,O.D.
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
1152W00000XOptometrist4760OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000199218OTHEROHANTHEM

General Provider Information

NPI Number : 1912051988
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENISE M. KUDER,O.D.
Provider Business Mailing Address
First Line : 35901 CHESTER RD
Second Line :
City : AVON
State : OH
Zip : 44011-1069
Country : US
Telephone Number : 440-937-4765
Fax Number :
Provider Business Practice Location Address
First Line : 35901 CHESTER RD
Second Line :
City : AVON
State : OH
Zip : 44011-1069
Country : US
Telephone Number : 440-937-4765
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. DENISE MICHELLE KUDER
Credential : O.D.
Telephone Number : 440-937-4765
Provider Enumeration Date : 01/23/2007
Last Update Date : 09/23/2020

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