Healthcare Provider Details

I. General information

NPI: 1083725089
Provider Name (Legal Business Name): DAVID A RUEDRICH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 10/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 BRADENTON AVE STE A
DUBLIN OH
43017-7589
US

IV. Provider business mailing address

3600 OLENTANGY RIVER RD SUITE 490
COLUMBUS OH
43214-3437
US

V. Phone/Fax

Practice location:
  • Phone: 614-793-8544
  • Fax: 615-793-8563
Mailing address:
  • Phone: 614-459-1000
  • Fax: 614-459-1382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number35051401
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: