Provider Demographics
NPI:1760644009
Name:RUDAY, WALTER JR (MSW)
Entity Type:Individual
Prefix:MR
First Name:WALTER
Middle Name:
Last Name:RUDAY
Suffix:JR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2748 UNIVERSITY BLVD W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-2123
Mailing Address - Country:US
Mailing Address - Phone:904-739-2242
Mailing Address - Fax:904-739-0171
Practice Address - Street 1:2748 UNIVERSITY BLVD W
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-2123
Practice Address - Country:US
Practice Address - Phone:904-739-2242
Practice Address - Fax:904-739-0171
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital