Healthcare Provider Details

I. General information

NPI: 1295908176
Provider Name (Legal Business Name): ANTHONY CLARK RUDINE M.D., M.B.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2008
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 N IH 35 PEDIATRIC NEONATOLOGY
AUSTIN TX
78739
US

IV. Provider business mailing address

200 LOTHROP ST FORBES TOWER SUITE 9055
PITTSBURGH PA
15213-2536
US

V. Phone/Fax

Practice location:
  • Phone: 512-844-5174
  • Fax: 412-232-8579
Mailing address:
  • Phone: 412-647-3087
  • Fax: 412-647-4486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD445245
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License NumberR1285
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberR1285
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: