Provider Demographics
NPI:1922081108
Name:RASH, TRUDI L (MD)
Entity Type:Individual
Prefix:
First Name:TRUDI
Middle Name:L
Last Name:RASH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:6801 DIXIE HWY
Mailing Address - Street 2:STE. 127
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-3913
Mailing Address - Country:US
Mailing Address - Phone:502-935-5633
Mailing Address - Fax:502-935-5706
Practice Address - Street 1:6801 DIXIE HWY
Practice Address - Street 2:STE.127
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-3913
Practice Address - Country:US
Practice Address - Phone:502-935-5633
Practice Address - Fax:502-935-5706
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2016-05-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY29127208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000047021OtherBLUE SHIELD