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General NPI Number Information
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NPI Number | 1093962581
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Entity Type | Individual
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Provider Name | UDO RUDLOFF MD
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Gender | Male
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Dates
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Enumeration Date | 08/26/2008
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Last Update Date | 12/30/2013
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Provider Practice Location Address
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Address Line | CENTER FOR CANCER RESEARCH CCR NCI NIH HATFIELD CENTER, ROOM 4-5940, 10 CENTER DRIVE
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City | BETHESDA
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State | MD
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Zip | 20892-0001
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Country | US
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Telephone | 301-496-3098
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Fax | 301-402-1788
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Provider Business Mailing Address
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Address Line | 4805 BROAD BROOK DR
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City | BETHESDA
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State | MD
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Zip | 20814-3905
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Country | US
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Telephone | 301-547-9226
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | MD2007-0633
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | 0101255226
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License Number State | VA
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