Provider Demographics
NPI:1134197841
Name:ZUBRICKY, CANDACE FOLLEY (MD)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:FOLLEY
Last Name:ZUBRICKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24651 CENTER RIDGE RD
Mailing Address - Street 2:STE 350
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5635
Mailing Address - Country:US
Mailing Address - Phone:440-895-5056
Mailing Address - Fax:440-333-2935
Practice Address - Street 1:25200 CENTER RIDGE RD
Practice Address - Street 2:SUITE 2000
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-4141
Practice Address - Country:US
Practice Address - Phone:440-331-3321
Practice Address - Fax:440-331-3373
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35063777Z207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
10801862OtherCAQH
1780634279OtherGROUP NPI
CA4511OtherRR MEDICARE GROUP
OH0969699Medicaid
3610861OtherGROUP ASC MEDICARE
D368301OtherGROUP IND DIAGNOSTICS MED
P00064895OtherRR MEDICARE INDIVIDUAL
0119204OtherGROUP MEDICAID
121423OtherKAISER
9273172OtherGROUP MEDICARE
9273172OtherGROUP MEDICARE
9273172OtherGROUP MEDICARE
OH0969699Medicaid