Provider Demographics
NPI:1578554739
Name:HUDSON, STEVEN J (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:HUDSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12 CHATHAM HEIGHTS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405-2566
Mailing Address - Country:US
Mailing Address - Phone:540-371-2777
Mailing Address - Fax:540-371-0922
Practice Address - Street 1:12 CHATHAM HEIGHTS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-2566
Practice Address - Country:US
Practice Address - Phone:540-371-2777
Practice Address - Fax:540-371-0922
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2014-01-27
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Provider Licenses
StateLicense IDTaxonomies
VA0101053014207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA101323976000Medicaid
VA021362A48OtherMEDICARE PTAN
VA132507Medicare UPIN
VA021362A48OtherMEDICARE PTAN