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General NPI Number Information
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NPI Number | 1992978522
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Entity Type | Organization
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Legal Business Name | PAUL A. TUDDER, M.D., F.A.C.O.G., P.C.
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Dates
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Enumeration Date | 04/03/2008
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Last Update Date | 08/07/2009
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Provider Practice Location Address
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Address Line | 821 S KING ST SUITE H
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City | LEESBURG
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State | VA
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Zip | 20175-3921
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Country | US
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Telephone | 703-777-6550
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Fax | 703-771-8021
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Provider Business Mailing Address
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Address Line | 821 S KING ST SUITE H
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City | LEESBURG
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State | VA
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Zip | 20175-3921
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Country | US
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Telephone | 703-777-6550
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Fax | 703-771-8021
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MELISSA CROSS
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Credential |
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Telephone | 703-777-6550
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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 | 0101033381
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License Number State | VA
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