Provider Demographics
NPI:1730124173
Name:HUDSON-FRALEY, ANITA M (MD)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:M
Last Name:HUDSON-FRALEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:102 HANDLEY PARK CT
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-1768
Mailing Address - Country:US
Mailing Address - Phone:919-734-3344
Mailing Address - Fax:919-736-1352
Practice Address - Street 1:102 HANDLEY PARK CT
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1768
Practice Address - Country:US
Practice Address - Phone:919-734-3344
Practice Address - Fax:919-736-1352
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96-00366207VG0400X
NC9600366207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G28799Medicare UPIN