MEDICARE: CHRISTINE D HUDAK MD

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	207Q00000X	Family Medicine Physician	35064240	OH

General Provider Information

NPI Number	:	1871583823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE D HUDAK MD

Provider Business Mailing Address
First Line	:	444 N MAIN ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44310-3110
Country	:	US
Telephone Number	:	330-379-5100
Fax Number	:	330-379-5177

Provider Business Practice Location Address
First Line	:	444 N MAIN ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44310-3110
Country	:	US
Telephone Number	:	330-379-5100
Fax Number	:	330-379-5177

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	01/25/2022

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