Individual
MATTHEW PUDERBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
715 S 8TH ST, MINNEAPOLIS, MN 55404-1210
(612) 873-3000
Mailing address
420 DELAWARE ST. SE, MMC 297, MINNEAPOLIS, MN 55455
(612) 625-2661
Taxonomy
Speciality
Code
Description
License number
State
2081P0301X
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
Primary
70248
MN
208D00000X
General Practice Physician
5101019889
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/17/2012
Last updated
06/10/2022
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