Individual
JASON ROSS RUDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3009 N BALLAS RD STE 380C, SAINT LOUIS, MO 63131
(314) 996-4790
(314) 996-4792
Mailing address
3009 N BALLAS RD STE 380C, SAINT LOUIS, MO 63131-2324
(314) 996-4790
(314) 996-4792
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
2019016866
MO
Other
Enumeration date
03/30/2014
Last updated
03/17/2021
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