Individual
DR. JOHN ANTHONY HUDAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6301 UNIVERSITY COMMONS, STE 350, SOUTH BEND, IN 46635-1571
(574) 234-4100
(574) 282-1739
Mailing address
211 N EDDY ST, SOUTH BEND, IN 46617-3096
(574) 234-4100
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01033777A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000086163
ANTHEM
—
05
—
100357400
—
IN
01
—
264180DD
MEDICARE PTAN
IN
Enumeration date
06/16/2005
Last updated
07/01/2024
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