Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 35051401 | OH |
NPI | 1083725089 |
---|---|
Provider Name | Dr. David A Ruedrich |
First Address | Columbus, OH 43214-3437 |
Second Address | Dublin, OH 43017-7589 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 28/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0117000 | (05) | OH |
311621914 | TAX ID (01) | OH |
4034302 | MEDICARE PTAN (01) | OH |