Individual
MALLORY HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5839 W MAPLE RD STE 100, WEST BLOOMFIELD, MI 48322-2278
(248) 862-7221
Mailing address
39555 ORCHARD HILL PL STE 600, NOVI, MI 48375-5381
(517) 484-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601010568
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/20/2021
Last updated
10/29/2025
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