Provider Demographics
NPI:1538106729
Name:HUDSON, MARY ALLISON SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:MARY ALLISON
Middle Name:SCOTT
Last Name:HUDSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ALLISON
Other - Last Name:POSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1814 EASTCHESTER DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-1403
Practice Address - Country:US
Practice Address - Phone:336-481-1830
Practice Address - Fax:336-481-1839
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200001420208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89127P6Medicaid
NC2281171BMedicare PIN
NC89127P6Medicaid
NC2281171AMedicare PIN