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General NPI Number Information
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NPI Number | 1619785631
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Entity Type | Individual
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Provider Name | CHARLES JOSEPH HUDSON IV CP
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Gender | Male
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Dates
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Enumeration Date | 12/23/2024
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 1502 PEMBERTON DR UNIT E
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City | SALISBURY
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State | MD
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Zip | 21801-2475
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Country | US
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Telephone | 443-667-2515
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Fax | 443-228-4598
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Provider Business Mailing Address
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Address Line | 7421 W HOLLAND AVE
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City | WILLARDS
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State | MD
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Zip | 21874-1288
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Country | US
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Telephone | 443-523-4079
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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 | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State |
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