Individual
MRS. SHANNON CHRISTINE HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDC
Contact information
Practice address
47149 BUSE RD, UNIT #1370, PATUXENT RIVER, MD 20670-1540
(301) 342-1429
Mailing address
2534 GUM WAY, APT C, LEXINGTON PARK, MD 20653-2288
(301) 342-1429
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710I1002X
INDEPENDENT DUTY CORPSMAN
MD
Enumeration date
03/15/2006
Last updated
10/20/2008
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