Provider Demographics
NPI:1396024477
Name:EHREDT, DUANE JOSEPH JR (DPM)
Entity type:Individual
Prefix:DR
First Name:DUANE
Middle Name:JOSEPH
Last Name:EHREDT
Suffix:JR
Gender:M
Credentials:DPM
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Mailing Address - Street 1:6000 ROCKSIDE WOODS BLVD N
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2330
Mailing Address - Country:US
Mailing Address - Phone:216-231-5612
Mailing Address - Fax:216-721-5534
Practice Address - Street 1:7000 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-4014
Practice Address - Country:US
Practice Address - Phone:216-241-8654
Practice Address - Fax:216-721-5534
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2024-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH36.003637213ES0103X, 213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine