Individual
MR. DAVID NATHANIEL HUDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 598-4615
(206) 520-5620
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 361-5601
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60540093
WA
363A00000X
Physician Assistant
PA9105965
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114661000
—
FL
05
—
1306144126
—
WA
01
—
PF167
MEDICARE HF
FL
Enumeration date
03/02/2011
Last updated
07/21/2022
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