Provider Demographics
NPI:1477156735
Name:DUDASH, CHARLES JOSEPH
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:JOSEPH
Last Name:DUDASH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8351 RALEIGH PL
Mailing Address - Street 2:
Mailing Address - City:CONCORD TWP
Mailing Address - State:OH
Mailing Address - Zip Code:44077-8546
Mailing Address - Country:US
Mailing Address - Phone:440-867-2618
Mailing Address - Fax:
Practice Address - Street 1:8351 RALEIGH PL
Practice Address - Street 2:
Practice Address - City:CONCORD TWP
Practice Address - State:OH
Practice Address - Zip Code:44077-8546
Practice Address - Country:US
Practice Address - Phone:440-867-2618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care