Individual
DR. DENNIS RUDDEROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 642-4100
Mailing address
116 WILLOW BROOK DR, SAINT LOUIS, MO 63146-5681
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2003017052
MO
Other
Enumeration date
10/12/2006
Last updated
07/08/2007
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