Provider Demographics
NPI:1538225750
Name:LUDWIG, DAVID JEROME (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JEROME
Last Name:LUDWIG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1974 12TH STREET PL NE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-1649
Mailing Address - Country:US
Mailing Address - Phone:828-328-7212
Mailing Address - Fax:828-328-7323
Practice Address - Street 1:324 2ND AVE SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-3043
Practice Address - Country:US
Practice Address - Phone:828-302-4777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0478103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist