Provider Demographics
NPI:1356382287
Name:LUDERS, HANS O
Entity type:Individual
Prefix:
First Name:HANS
Middle Name:O
Last Name:LUDERS
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 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-3192
Practice Address - Fax:216-844-3014
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350429792084P0005X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P0005XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurodevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000221068OtherUNISON
OH4472714OtherAETNA
OH732360OtherBUCKEYE MEDICAID
OHP00428933OtherMEDICARE RAILROAD
OH0447958Medicaid
MI1356382287OtherMICHIGAN MEDICAID
OH415005OtherWELLCARE MEDICAID
PA0016294720002Medicaid
OH000000510692OtherANTHEM
OH000000510692OtherANTHEM
OH4472714OtherAETNA