Healthcare Provider Details

I. General information

NPI: 1811688823
Provider Name (Legal Business Name): ALEXA CASSIDY DUDDING PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 MUSGROVE RD STE 105
SILVER SPRING MD
20904-5224
US

IV. Provider business mailing address

2415 MUSGROVE RD STE 105
SILVER SPRING MD
20904-5224
US

V. Phone/Fax

Practice location:
  • Phone: 301-989-0193
  • Fax: 301-879-2325
Mailing address:
  • Phone: 301-989-0193
  • Fax: 301-879-2323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0110009432
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0009223
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: