Doctor Name: | JOHN RUDOFF |
NPI Number: | 1043291024 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD16036 |
Business Practice Address: | 6475 Sw Borland Rd Tualatin, OR - 970629708 |
Business Phone Number: | 5032388333 |
Business Fax Number: | 5038859033 |
Mailing Address: | 6475 Sw Borland Rd, TUALATIN |
State: | OR |
Postal Code: | 970629708 |
Phone Number: | 5032388333 |
Fax Number: | 5038859033 |
NPI Enumeration Date: | 11/08/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD16036 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |