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NPI Code Detail

MEDICARE: DR. JENNIFER FUDGE PLAYER MD

MEDICARE: DR. JENNIFER FUDGE PLAYER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician2006-00404NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194725036
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER FUDGE PLAYER MD
Provider Business Mailing Address
First Line : 1914 GLEN MEADE RD
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-6025
Country : US
Telephone Number : 910-762-2651
Fax Number : 910-763-5709
Provider Business Practice Location Address
First Line : 1914 GLEN MEADE RD
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-6025
Country : US
Telephone Number : 910-762-2651
Fax Number : 910-763-5709
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 07/25/2011

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