Individual
CLARISSA M DUDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2916
(202) 476-5500
(202) 476-5877
Mailing address
PO BOX 37215, BALTIMORE, MD 21297-3215
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101840524
VA
208000000X
Pediatrics Physician
Primary
MD037670
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010051487
—
VA
Enumeration date
05/07/2008
Last updated
10/23/2008
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