Provider Demographics
NPI:1659337921
Name:DRS. HUDDLESTON & DINARDO PA
Entity Type:Organization
Organization Name:DRS. HUDDLESTON & DINARDO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTJON
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDDLESTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-749-1171
Mailing Address - Street 1:106 MILFORD ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-6953
Mailing Address - Country:US
Mailing Address - Phone:410-749-1171
Mailing Address - Fax:410-749-9269
Practice Address - Street 1:106 MILFORD ST
Practice Address - Street 2:SUITE 103
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-6953
Practice Address - Country:US
Practice Address - Phone:410-749-1171
Practice Address - Fax:410-749-9269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD=========OtherTIN
MDK623Medicare PIN