Individual
MRS. DIANNE KAY TRUDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
G-5085 WEST BRISTOL RD, FLINT, MI 48507-2922
(810) 230-2400
(810) 230-1616
Mailing address
G-5085 WEST 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
BLUE CROSS BLUE SHIELD
MI
01
—
1826025002
HEALTH PLUS
MI
05
—
1996631
—
MI
01
—
4092874
AETNA
MI
01
—
C1542
M-CARE
MI
01
—
P60370
BLUE CARE NETWORK
MI
Enumeration date
08/23/2006
Last updated
03/18/2015
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