Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081S0010X | Sports Medicine | 36.003637 | OH |
N | 213ES0000X | Sports Medicine | 36.003637 | OH |
Y | 213ES0103X | Foot & Ankle Surgery | 36.003637 | OH |
NPI | 1396024477 |
---|---|
Provider Name | Dr. Duane Joseph Ehredt JR. |
First Address | Cleveland, OH 44193-0008 |
Second Address | Cleveland, OH 44103-4014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2011 |
Last Update Date | 03/02/2021 |