Healthcare Provider Details

I. General information

NPI: 1922268846
Provider Name (Legal Business Name): EMILY DIANA KERINS RUEDINGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2008
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 WAUSHARA CIR
MADISON WI
53705-4818
US

IV. Provider business mailing address

5 WAUSHARA CIR
MADISON WI
53705-4818
US

V. Phone/Fax

Practice location:
  • Phone: 608-712-6441
  • Fax:
Mailing address:
  • Phone: 608-712-6441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number71665-20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberMD60513631
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD60513631
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: