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General NPI Number Information
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NPI Number | 1063006872
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Entity Type | Individual
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Provider Name | MARIA PAULA TRUDEAU PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/22/2021
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 349 PENNY LN
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City | CONCORD
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State | NC
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Zip | 28025-1221
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Country | US
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Telephone | 704-786-7158
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Fax |
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Provider Business Mailing Address
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Address Line | 1523 CRESCENT LN APT G
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City | MATTHEWS
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State | NC
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Zip | 28105-2340
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Country | US
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Telephone | 305-528-4659
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0010-15514
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-15514
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License Number State | NC
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