Provider Demographics
NPI:1194977793
Name:ZUDER, MYRON G (PH D)
Entity type:Individual
Prefix:
First Name:MYRON
Middle Name:G
Last Name:ZUDER
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-3017
Mailing Address - Country:US
Mailing Address - Phone:330-762-7481
Mailing Address - Fax:330-762-7484
Practice Address - Street 1:640 N MAIN ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-3017
Practice Address - Country:US
Practice Address - Phone:330-762-7481
Practice Address - Fax:330-762-7484
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0001405106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist