Provider Demographics
NPI:1679510382
Name:HUDSON FABIAN, KORIN B (MD)
Entity Type:Individual
Prefix:DR
First Name:KORIN
Middle Name:B
Last Name:HUDSON FABIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KORIN
Other - Middle Name:B
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6858 OLD DOMINION DR STE 202
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3899
Mailing Address - Country:US
Mailing Address - Phone:703-288-2790
Mailing Address - Fax:703-288-2799
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2976
Practice Address - Country:US
Practice Address - Phone:202-877-7632
Practice Address - Fax:610-834-2862
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAE0101238136207PS0010X
DCMD035967207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PS0010XAllopathic & Osteopathic PhysiciansEmergency MedicineSports Medicine