| Doctor Name: | UBALDO R RODRIGUEZ |
| NPI Number: | 1649231275 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 29894 |
| Business Practice Address: | 1600 Heritage Lndg Ste 215 Saint Peters, MO - 633038489 |
| Business Phone Number: | 6369394200 |
| Business Fax Number: | 6369394204 |
| Mailing Address: | 1600 Heritage Lndg, Ste 215 SAINT PETERS |
| State: | MO |
| Postal Code: | 633038489 |
| Phone Number: | 6369394200 |
| Fax Number: | 6369394204 |
| NPI Enumeration Date: | 03/31/2006 |
| NPI Last Update Date: | 07/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 29894 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |