Provider Demographics
NPI:1942405048
Name:OUDEN, MICHAEL (CSA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:OUDEN
Suffix:
Gender:M
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8116 ARLINGTON BLVD STE 183
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1002
Mailing Address - Country:US
Mailing Address - Phone:202-491-7688
Mailing Address - Fax:866-547-7953
Practice Address - Street 1:8116 ARLINGTON BLVD STE 183
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1002
Practice Address - Country:US
Practice Address - Phone:202-491-7688
Practice Address - Fax:866-547-7953
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
2925OtherNCCSA