Individual
DR. SAMUEL CALVERT DUDLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 672-6000
Mailing address
420 DELAWARE STREET SE, MINNEAPOLIS, MN 55455
(612) 624-8970
(612) 626-4411
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
044910
GA
207RC0000X
Cardiovascular Disease Physician
336.080316
IL
207RC0000X
Cardiovascular Disease Physician
Primary
MD14147
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD14147
PROFESSIONAL LICENSE
RI
Enumeration date
08/16/2006
Last updated
11/01/2017
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