Provider Demographics
NPI:1134216534
Name:TRUDEAU, JAMES E (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:TRUDEAU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 VOLVO PKWY
Mailing Address - Street 2:STE 118
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2811
Mailing Address - Country:US
Mailing Address - Phone:757-436-6677
Mailing Address - Fax:757-436-6789
Practice Address - Street 1:801 VOLVO PKWY
Practice Address - Street 2:STE 118
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2811
Practice Address - Country:US
Practice Address - Phone:757-436-6677
Practice Address - Fax:757-436-6789
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01040001182111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA073645OtherANTHEM BCBS
VA9520112Medicaid
VA350000441Medicare ID - Type Unspecified