Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 271601 | NY |
Y | 2080P0208X | Pediatric Infectious Diseases | 55392 | AZ |
NPI | 1467766311 |
---|---|
Provider Name | Dr. Daniel Ruderfer |
First Address | Tucson, AZ 85751-1235 |
Second Address | Tucson, AZ 85712-2155 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2010 |
Last Update Date | 12/09/2019 |