Basic Information
Provider Information
NPI: 1821450586
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CURAUDEAU
FirstName: GUILLAUME
MiddleName: A.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5757 PARK CENTER CT.
Address2:  
City: TOLEDO
State: OH
PostalCode: 43615
CountryCode: US
TelephoneNumber: 4194744064
FaxNumber: 4194722772
Practice Location
Address1: 5757 PARK CENTER CT.
Address2:  
City: TOLEDO
State: OH
PostalCode: 43615
CountryCode: US
TelephoneNumber: 4194744064
FaxNumber: 4194722772
Other Information
ProviderEnumerationDate: 03/22/2016
LastUpdateDate: 08/09/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
2085R0202X272239MAY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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