Provider Demographics
NPI:1750348918
Name:DULDNER, JOHN E JR (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:DULDNER
Suffix:JR
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 1:21755 BROOKPARK ROAD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44126
Mailing Address - Country:US
Mailing Address - Phone:440-777-6300
Mailing Address - Fax:440-777-2330
Practice Address - Street 1:400 WABASH AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307
Practice Address - Country:US
Practice Address - Phone:330-344-1799
Practice Address - Fax:330-253-8293
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35067800207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0169839Medicaid
OH0169839Medicaid
G14348Medicare UPIN
OHDU0806497Medicare PIN