Provider Demographics
NPI:1104184654
Name:OLSON, TARA HUDAK (MD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:HUDAK
Last Name:OLSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:MARIE
Other - Last Name:HUDAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26005 RIDGE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DAMASCUS
Mailing Address - State:MD
Mailing Address - Zip Code:20872-1892
Mailing Address - Country:US
Mailing Address - Phone:301-414-2300
Mailing Address - Fax:301-414-0476
Practice Address - Street 1:26005 RIDGE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:DAMASCUS
Practice Address - State:MD
Practice Address - Zip Code:20872-1892
Practice Address - Country:US
Practice Address - Phone:301-414-2300
Practice Address - Fax:301-414-0476
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0081604207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology