Basic Information
| Provider Information | |||||||||
| NPI: | 1003178427 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOUDON | ||||||||
| FirstName: | ANDREW | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8055 MAYFIELD RD STE 105 | ||||||||
| Address2: | |||||||||
| City: | CHESTERLAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440262447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402148026 | ||||||||
| FaxNumber: | 2162017963 | ||||||||
| Practice Location | |||||||||
| Address1: | 11100 EUCLID AVE | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441061716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2168447981 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2012 | ||||||||
| LastUpdateDate: | 12/29/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 57.030517 | OH | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 390200000X | TRN17652 | FL | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2086S0127X | 35.134079 | OH | Y | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery |
No ID Information.