Individual
RICHARD SCUDERI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1701 S CREASY LN, LAFAYETTE, IN 47905-4972
(765) 502-4000
(765) 502-4709
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01077039A
IN
207R00000X
Internal Medicine Physician
036.146123
IL
208M00000X
Hospitalist Physician
Primary
01077039A
IN
208M00000X
Hospitalist Physician
036.146123
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/07/2013
Last updated
05/22/2023
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