Provider Demographics
NPI:1760608954
Name:HUDSON, CHARLENE (DO)
Entity Type:Individual
Prefix:DR
First Name:CHARLENE
Middle Name:
Last Name:HUDSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2244 SUNSTATES CT
Mailing Address - Street 2:SUITE 106
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-1552
Mailing Address - Country:US
Mailing Address - Phone:757-256-7049
Mailing Address - Fax:757-496-5817
Practice Address - Street 1:2244 SUNSTATES CT
Practice Address - Street 2:SUITE 106
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-1552
Practice Address - Country:US
Practice Address - Phone:757-256-7049
Practice Address - Fax:757-496-5817
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A9818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine