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General NPI Number Information
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NPI Number | 1013104843
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Entity Type | Organization
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Legal Business Name | DONALD E. CHUDY, DPM, PC
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 08/20/2008
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Provider Practice Location Address
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Address Line | 4824 E BASELINE RD SUITE 107
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City | MESA
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State | AZ
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Zip | 85206-4676
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Country | US
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Telephone | 480-964-1715
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Fax | 480-834-5525
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Provider Business Mailing Address
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Address Line | 4824 E BASELINE RD SUITE 107
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City | MESA
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State | AZ
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Zip | 85206-4676
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Country | US
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Telephone | 480-964-1715
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Fax | 480-834-5525
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Authorized Official
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Title or Position | OFFICE SUPERVISOR
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Name | MRS. SUSAN L CHUDY
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Credential |
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Telephone | 480-964-1715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0202
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License Number State | AZ
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