Provider Demographics
NPI:1720078520
Name:CUDIHY, DAMON T (MD)
Entity Type:Individual
Prefix:DR
First Name:DAMON
Middle Name:T
Last Name:CUDIHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:155 HOSPITAL DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2636
Mailing Address - Country:US
Mailing Address - Phone:337-261-5433
Mailing Address - Fax:337-269-9652
Practice Address - Street 1:1211 COOLIDGE BLVD
Practice Address - Street 2:SUITE 403
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2636
Practice Address - Country:US
Practice Address - Phone:337-261-5433
Practice Address - Fax:337-269-9652
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD436149207V00000X
GA055817207V00000X
LAMD206213207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA161032Medicare PIN