| Doctor Name: | MR. CHARLES A TUDOR |
| NPI Number: | 1043350242 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 101593 |
| Business Practice Address: | 1130 Grace Meadow Dr Mooresville, NC - 281152789 |
| Business Phone Number: | 7046634989 |
| Business Fax Number: | |
| Mailing Address: | 1130 Grace Meadow Dr, MOORESVILLE |
| State: | NC |
| Postal Code: | 281152789 |
| Phone Number: | 7046634989 |
| Fax Number: | |
| NPI Enumeration Date: | 02/07/2007 |
| NPI Last Update Date: | 10/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 101593 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |