Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 0101 033691 | VA |
NPI | 1013970920 |
---|---|
Provider Name | Dr. Douglas H. Ludeman JR. |
First Address | Richmond, VA 23235 |
Second Address | Richmond, VA 23235 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2006 |
Last Update Date | 28/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
007567855 | (05) | VA |
1900002 | UNITED HEALTHCARE (01) | VA |
224680123 | TRICARE (01) | VA |
24391 | ALLIANCE (01) | VA |
2583 | CIGNA (01) | VA |
340013655 | RAILROAD MEDICARE (01) | VA |
36715 | CARENET (01) | VA |
4063512 | AETNA PPO (01) | VA |
59299 | SOUTHERN HEALTH (01) | VA |
642072000-00 | QUALCHOICE (01) | VA |
68482 | SENTARA FAMILY CARE (01) | VA |
790522 | AETNA HMO (01) | VA |
C01241 | MEDICARE GROUP # (01) | VA |
C36721 | (02) | VA |
CL9160 | RAILROAD MEDICARE GROUP # (01) | VA |