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Individual

RUDY MARTIN TEDJA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1155 MILL ST, RENO, NV 89502
(775) 982-7878
(775) 982-4196
Mailing address
850 HARVARD WAY, RENO, NV 89502-2055
(775) 982-5262
(775) 982-5496

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
20A13497
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
57113
MN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
DO2441
NV
207RI0200X
Infectious Disease Physician
34.009823
OH
207RI0200X
Infectious Disease Physician
DO2441
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14271792
CAQH
Enumeration date
04/28/2008
Last updated
09/21/2018
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