Provider Demographics
NPI:1710911094
Name:RUDE, GILBERT A (MD)
Entity Type:Individual
Prefix:
First Name:GILBERT
Middle Name:A
Last Name:RUDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-3392
Mailing Address - Country:US
Mailing Address - Phone:308-865-2767
Mailing Address - Fax:308-865-2765
Practice Address - Street 1:3907 6TH AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-3392
Practice Address - Country:US
Practice Address - Phone:308-865-2767
Practice Address - Fax:308-865-2765
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14089207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE13957OtherMIDLAND'S CHOICE
NE07449OtherBCBS
NE07449OtherBCBS
NE096037Medicare ID - Type Unspecified