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NPI Code Detail

MEDICARE: DR. ANDREW J RUDEN

MEDICARE:  DR. ANDREW J RUDEN
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
1208D00000XGeneral Practice Physician4301040917MI

General Provider Information

NPI Number : 1881717049
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW J RUDEN
Provider Business Mailing Address
First Line : 29600 S WIXOM RD
Second Line :
City : WIXOM
State : MI
Zip : 48393-3430
Country : US
Telephone Number : 248-926-8459
Fax Number : 248-926-1310
Provider Business Practice Location Address
First Line : 29600 S WIXOM RD
Second Line :
City : WIXOM
State : MI
Zip : 48393-3430
Country : US
Telephone Number : 248-926-8459
Fax Number : 248-926-1310
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 07/09/2007

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Directions to “ DR. ANDREW J RUDEN ” Practice Location

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