Individual
DR. SUSAN M. FUDGE-ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3555 LUTHERAN PARKWAY, SUITE 200, WHEAT RIDGE, CO 80033-6027
(720) 284-3700
(303) 467-0525
Mailing address
3555 LUTHERAN PARKWAY, SUITE 200, WHEAT RIDGE, CO 80033-6027
(720) 284-3700
(303) 467-0525
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
34593
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01345933
—
CO
Enumeration date
07/19/2006
Last updated
02/23/2012
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