Individual
DR. MARY ANN S PUDIMAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
61 EMERALD GLEN LANE, SALEM, CT 06420
(860) 887-9073
(860) 887-9073
Mailing address
3998 FAIR RIDGE DR, SUITE 300, FAIRFAX, VA 22033-2907
(703) 295-9360
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
037961
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001379610
—
CT
Enumeration date
08/31/2005
Last updated
03/16/2015
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