Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 0101256220 | VA |
NPI | 1003923095 |
---|---|
Provider Name | Donald J. Dudley |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22908-2824 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 14/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003923095 | (05) | VA |