Provider Demographics
NPI:1114273695
Name:CHUDE, SHEVONNE
Entity Type:Individual
Prefix:
First Name:SHEVONNE
Middle Name:
Last Name:CHUDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1838 GREENE TREE RD STE 340
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-7116
Mailing Address - Country:US
Mailing Address - Phone:410-602-3376
Mailing Address - Fax:
Practice Address - Street 1:1838 GREENE TREE RD STE 340
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-7116
Practice Address - Country:US
Practice Address - Phone:410-602-3376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical