Individual
DR. DONALD HENRY RUDICK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
761 JOHNSONBURG RD, SUITE 350, ST MARYS, PA 15857-3483
(814) 781-8669
(814) 781-8671
Mailing address
761 JOHNSONBURG RD, SUITE 350, ST MARYS, PA 15857-3483
(814) 781-8669
(814) 781-8671
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD056864L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019212650001
—
PA
01
—
1444738
HIGHMARK PROVIDER NUMBER
PA
Enumeration date
05/09/2006
Last updated
07/09/2007
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