Provider Demographics
NPI:1013970920
Name:LUDEMAN, DOUGLAS H JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:H
Last Name:LUDEMAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9101 STONY POINT DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235
Mailing Address - Country:US
Mailing Address - Phone:804-330-9105
Mailing Address - Fax:804-287-6119
Practice Address - Street 1:9101 STONY POINT DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235
Practice Address - Country:US
Practice Address - Phone:804-330-9105
Practice Address - Fax:804-287-6119
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101 033691208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4063512OtherAETNA PPO
VA68482OtherSENTARA FAMILY CARE
VA2583OtherCIGNA
VA642072000-00OtherQUALCHOICE
VA340013655OtherRAILROAD MEDICARE
VA1900002OtherUNITED HEALTHCARE
VAC01241OtherMEDICARE GROUP #
VA224680123OtherTRICARE
VACL9160OtherRAILROAD MEDICARE GROUP #
VA24391OtherALLIANCE
VA007567855Medicaid
VA36715OtherCARENET
VA59299OtherSOUTHERN HEALTH
VA790522OtherAETNA HMO
VA790522OtherAETNA HMO