Individual
IDA HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
800 SPRUCE ST, PHILA, PA 19107-6130
(215) 829-5664
Mailing address
4400 EMERSON RD, WILMINGTON, DE 19802-1210
(302) 764-7060
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
010076L
PA
Other
Enumeration date
11/01/2005
Last updated
01/05/2010
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