MEDICARE: DAWN MARIE RUDD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	M5474	TX

General Provider Information

NPI Number	:	1669441937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN MARIE RUDD MD

Provider Business Mailing Address
First Line	:	600 DIVISION AVE STE E
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78214-1336
Country	:	US
Telephone Number	:	210-364-9961
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 DIVISION AVE STE E
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78214-1336
Country	:	US
Telephone Number	:	210-364-9961
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	08/14/2023

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