Individual
KIM LOUISE FUDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
ERIE AVE AT FRONT ST, ST CHRISTOPHER'S HOSPITAL FOR CHILDREN, PHILADELPHIA, PA 19134
(215) 427-8190
(215) 427-4638
Mailing address
ERIE AVE AT FRONT ST, ST CHRISTOPHERS HOSPITAL FOR CHILDREN, PHILADELPHIA, PA 19027-1095
(215) 427-8190
(215) 427-4638
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA-002885-L
PA
Other
Enumeration date
09/18/2008
Last updated
05/21/2024
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