Individual
RUDY MARTIN TEDJA
Active
Individual
RUDY MARTIN TEDJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
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
Update your record
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