Provider Demographics
NPI:1609030063
Name:RUDD, JOSHUA DAVID (DO)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DAVID
Last Name:RUDD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:40 BRETTWOOD TRCE
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-8021
Mailing Address - Country:US
Mailing Address - Phone:828-452-5042
Mailing Address - Fax:828-452-9225
Practice Address - Street 1:40 BRETTWOOD TRCE
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-8021
Practice Address - Country:US
Practice Address - Phone:828-456-8633
Practice Address - Fax:828-452-2792
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2023-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2010-00864208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2403245AMedicare PIN