Provider Demographics
NPI:1043647647
Name:DULUDE, EVERT MICHAEL
Entity Type:Individual
Prefix:
First Name:EVERT
Middle Name:MICHAEL
Last Name:DULUDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:E.
Other - Middle Name:MICHAEL
Other - Last Name:DULUDE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6933 CHORALE CT
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89433-6686
Mailing Address - Country:US
Mailing Address - Phone:775-530-9705
Mailing Address - Fax:
Practice Address - Street 1:6933 CHORALE CT
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:NV
Practice Address - Zip Code:89433-6686
Practice Address - Country:US
Practice Address - Phone:775-530-9705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner