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General NPI Number Information
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NPI Number | 1427968585
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Entity Type | Individual
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Provider Name | MICHAEL ANDREW RUDDER
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Gender | Male
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Dates
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Enumeration Date | 09/10/2026
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Last Update Date | 09/10/2026
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Provider Practice Location Address
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Address Line | 8330 TERRACE RD NE
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City | MINNEAPOLIS
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State | MN
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Zip | 55432-1158
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Country | US
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Telephone | 651-706-7026
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 RED VENTURES DR
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City | FORT MILL
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State | SC
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Zip | 29707-5005
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Country | US
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Telephone | 980-785-0567
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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