Provider Demographics
NPI:1295794592
Name:JUDE, DAVID C (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:JUDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1600 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 4500
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3656
Mailing Address - Country:US
Mailing Address - Phone:304-691-1400
Mailing Address - Fax:304-691-1453
Practice Address - Street 1:1600 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 4500
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3656
Practice Address - Country:US
Practice Address - Phone:304-691-1400
Practice Address - Fax:304-691-1453
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2021-11-16
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Provider Licenses
StateLicense IDTaxonomies
WV17555207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64700057Medicaid
OH0960214Medicaid
WV0092729000Medicaid
OH0960214Medicaid
WVE53333Medicare UPIN