Provider Demographics
NPI:1033374186
Name:RUDERSDORF, PATRICK DONOHUE (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:DONOHUE
Last Name:RUDERSDORF
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11700 W 2ND PL
Mailing Address - Street 2:SUITE 280
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1704
Mailing Address - Country:US
Mailing Address - Phone:720-321-8680
Mailing Address - Fax:720-321-8681
Practice Address - Street 1:11700 W 2ND PL
Practice Address - Street 2:SUITE 280
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1704
Practice Address - Country:US
Practice Address - Phone:720-321-8680
Practice Address - Fax:720-321-8681
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2015-10-30
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Provider Licenses
StateLicense IDTaxonomies
CODR.0055303208G00000X, 208600000X
CAA113303208G00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery