Provider Demographics
NPI:1992765572
Name:HUDAK, ANNE M (MD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:HUDAK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1201 BROADROCK BLVD, BLDG 514
Mailing Address - Street 2:MCQUIRE VA MEDICAL CENTER, DEPT OF PM&R
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23249
Mailing Address - Country:US
Mailing Address - Phone:804-675-5117
Mailing Address - Fax:804-675-5857
Practice Address - Street 1:1201 BROADROCK BLVD, BLDG 514
Practice Address - Street 2:MCQUIRE VA MEDICAL CENTER, DEPT OF PM&R
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249
Practice Address - Country:US
Practice Address - Phone:804-675-5117
Practice Address - Fax:804-675-5857
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2013-01-28
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Provider Licenses
StateLicense IDTaxonomies
VA0101250335208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149695201Medicaid
TX149695201Medicaid
TX8892N1Medicare ID - Type Unspecified