Provider Demographics
NPI:1972632875
Name:CHIUNDA, STELLA (DPM)
Entity Type:Individual
Prefix:DR
First Name:STELLA
Middle Name:
Last Name:CHIUNDA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9591 COVINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-6091
Mailing Address - Country:US
Mailing Address - Phone:216-641-7255
Mailing Address - Fax:
Practice Address - Street 1:4415 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-3759
Practice Address - Country:US
Practice Address - Phone:216-231-5612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2008-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH003430213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2767573Medicaid
OH1563848OtherMEDICAID GROUP CFAC
OH9312431Medicare PIN
OH4213322Medicare PIN
OH1563848OtherMEDICAID GROUP CFAC