Individual
DR. JOHN H. RUDERSDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5200 DTC PKWY STE 400, GREENWOOD VILLAGE, CO 80111-2719
(303) 745-0000
(303) 773-3101
Mailing address
1500 S 48TH ST, SUITE 800, LINCOLN, NE 68506-1225
(402) 483-8600
(402) 483-8689
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
19484
CO
207RP1001X
Pulmonary Disease Physician
12882
NE
207RP1001X
Pulmonary Disease Physician
19484
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290008584
RAILROAD MEDICARE
NE
05
—
47080292200
—
NE
Enumeration date
03/16/2006
Last updated
12/04/2018
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