Fudge, Marilyn W
Fudge, Marilyn W is an individual health care provider with primary practice located at 700 6Th St S , St Petersburg FL 33701-4815. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Fudge, Marilyn W can be contacted via phone (727) 893-6198.Contact Information
Primary practice address
700 6Th St S
St Petersburg FL 33701-4815
Phone: (727) 893-6198
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | ME79050 | Florida |
Profile Details
| NPI number | 1306822887 |
|---|---|
| LBN Legal business name | Fudge, Marilyn W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 16th, 2005 |
| Last updated | May 21st, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306822887 | NPPES |
| Florida | MEDICAID | 264650100 |
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