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NPI Code Detail

MEDICARE: DR. SCOTT EDWIN RUDER MD

MEDICARE: DR. SCOTT EDWIN RUDER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician025663TN

General Provider Information

NPI Number : 1790733939
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT EDWIN RUDER MD
Provider Business Mailing Address
First Line : 3 MIDDLETON PARK LN
Second Line :
City : NASHVILLE
State : TN
Zip : 37215-5323
Country : US
Telephone Number : 615-327-3620
Fax Number : 615-329-0659
Provider Business Practice Location Address
First Line : 345 24TH AVE N
Second Line : STE 208
City : NASHVILLE
State : TN
Zip : 37203-1520
Country : US
Telephone Number : 615-327-3620
Fax Number : 615-329-0659
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 07/08/2007

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