1316946320 NPI number — DR. MARIA A CUDA D.O.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316946320 NPI number — DR. MARIA A CUDA D.O.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

CUDA

Provider First Name:

MARIA

Provider Middle Name:

A

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

D.O.

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1316946320

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

03/04/2026

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

130 SKYLINE DR

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

EVANSTON

Provider Business Mailing Address State Name:

WY

Provider Business Mailing Address Postal Code:

82930-5419

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

315-250-2435

Provider Business Mailing Address Fax Number:

260-285-5989

Provider First Line Business Practice Location Address:

130 SKYLINE DR

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

EVANSTON

Provider Business Practice Location Address State Name:

WY

Provider Business Practice Location Address Postal Code:

82930-5419

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

315-250-2435

Provider Business Practice Location Address Fax Number:

260-285-5989

Provider Enumeration Date:

07/20/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207Q00000X , with the licence number:  3362 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 208M00000X , with the licence number: 02003969A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 208M00000X , with the licence number: 10034A , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: OS0008953L . This is a "MEDICAL LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 201047820 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 247703 . This is a "STATE LICENSE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 000001055014 . This is a "ANTHEM" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
• Identifier: 02003969A . This is a "MEDICAL LICENSE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
• Identifier: 435827 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
• Identifier: OP00001657 . This is a "STATE MEDICAL LICENSE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 3362 . This is a "ARIZONA MEDICAL LICENSE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
• Identifier: 233863700 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".