Provider Demographics
NPI:1639205651
Name:DUDLEY, CALMEZE HENIKE JR (MD)
Entity Type:Individual
Prefix:
First Name:CALMEZE
Middle Name:HENIKE
Last Name:DUDLEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:C
Other - Middle Name:H
Other - Last Name:DUDLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3290 W BIG BEAVER RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-2903
Mailing Address - Country:US
Mailing Address - Phone:248-290-2220
Mailing Address - Fax:248-290-4019
Practice Address - Street 1:3290 W BIG BEAVER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-2903
Practice Address - Country:US
Practice Address - Phone:248-290-2220
Practice Address - Fax:248-290-4019
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2022-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010479392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry