Individual
MR. RUSI A UDWADIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4048 EVANS AVE, SUITE 209, FORT MYERS, FL 33901-9385
(239) 278-9983
(239) 278-9985
Mailing address
4048 EVANS AVE #209, # 2, FORT MYERS, FL 33901-9385
(239) 278-9983
(239) 278-9985
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
103123-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00686966
—
NY
Enumeration date
06/14/2006
Last updated
08/04/2015
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