Provider Demographics
NPI:1619956000
Name:BRIDGES, CLAUDE MUSTAFA (MD)
Entity Type:Individual
Prefix:
First Name:CLAUDE
Middle Name:MUSTAFA
Last Name:BRIDGES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6540 WINTON RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-1391
Mailing Address - Country:US
Mailing Address - Phone:513-981-4180
Mailing Address - Fax:513-541-3819
Practice Address - Street 1:6540 WINTON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-1391
Practice Address - Country:US
Practice Address - Phone:513-981-4180
Practice Address - Fax:513-541-3819
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN42615208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN984638700Medicaid
MN984638700Medicaid
H20487Medicare UPIN