MEDICARE: EUGENE O HUDYMA DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	00888	MD

General Provider Information

NPI Number	:	1174793087
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EUGENE O HUDYMA DPM

Provider Business Mailing Address
First Line	:	7836 OAKWOOD RD STE A
Second Line	:
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-4298
Country	:	US
Telephone Number	:	410-768-6011
Fax Number	:	410-768-6012

Provider Business Practice Location Address
First Line	:	7836 OAKWOOD RD STE A
Second Line	:
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-4298
Country	:	US
Telephone Number	:	410-768-6011
Fax Number	:	410-768-6012

Authorized Official
Title or Position	:	ACCOUNTS
Name	:	MRS. JOYCE JOHNSTON
Credential	:
Telephone Number	:	410-768-6011

Provider Enumeration Date	:	03/06/2008
Last Update Date	:	03/06/2008

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