Organization
DIANNE KAY TRUDELL, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN SOPKO (OFFICE MANAGER)
(810) 230-1790
Entity
Organization
Contact information
Practice address
5085 W BRISTOL RD, FLINT, MI 48507-2922
(810) 230-2400
(810) 230-1616
Mailing address
5085 W BRISTOL RD, FLINT, MI 48507-2922
(810) 230-2400
(810) 230-1616
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
DT048800
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102511962
BCBS PIN
MI
01
—
1826025002
GENESEE HEALTH PLAN
MI
05
—
1996631
—
MI
01
—
4092874
AETNA
MI
01
—
C1542
MCARE
MI
01
—
E38039
UPIN
MI
Enumeration date
04/30/2008
Last updated
03/18/2015
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