Provider Demographics
NPI:1093283327
Name:LUDINGTON, CUTLER ERHARDT (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CUTLER
Middle Name:ERHARDT
Last Name:LUDINGTON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1675 LEAHY ST STE 401A
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-5547
Mailing Address - Country:US
Mailing Address - Phone:231-727-4243
Mailing Address - Fax:231-727-4262
Practice Address - Street 1:1675 LEAHY ST STE 401A
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-5547
Practice Address - Country:US
Practice Address - Phone:231-727-4243
Practice Address - Fax:231-727-4262
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601008824363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant