Individual
HEATHER RUDDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2000 HAMILTON ST STE 301, PHILADELPHIA, PA 19130-3874
(215) 774-1166
(215) 279-8383
Mailing address
401 ROUTE 73 N, BLDG 10, SUITE 320, MARLTON, NJ 08053
(215) 774-1166
(215) 279-8383
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA08898000
NJ
208000000X
Pediatrics Physician
MD056728
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01670460
—
PA
Enumeration date
05/27/2006
Last updated
03/27/2023
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