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Individual
CARLOS ANDRES RUEDA MANTILLA
Active
Individual
CARLOS ANDRES RUEDA MANTILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125075440
IL
207RN0300X
Nephrology Physician
Primary
MD2025-0400
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7S1691
MEDICARE
NM
Enumeration date
08/07/2020
Last updated
08/01/2025
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