# MR. LAWRENCE L RUDER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1053388660
- **Gender:** Man
- **Credential:** MA CCCA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | 867 | KS | Yes |

## Other

- **Enumeration date:** 03/02/2006
- **Last updated:** 10/27/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100398800A | — | KS |
| 01 | — | 14105034 | BCBS OF KANSAS CITY | — |
| 01 | — | 481106646 | HUMANA | — |
| 01 | — | 640004509 | TRAVELERS MEDICARE | — |
| 01 | — | 7184252 | AETNA | — |
| 01 | — | LE714 | HEARING AID DISPENSING LI | KS |
| 01 | — | P33678 | COVENTRY | — |