Provider Demographics
NPI:1356024988
Name:BRUDERER, MADELIENE
Entity type:Individual
Prefix:
First Name:MADELIENE
Middle Name:
Last Name:BRUDERER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CU2RE PROGRAM - DEPT. OF FAMILY AND COMMUNITY MEDICINE
Mailing Address - Street 2:930 20TH STREET SOUTH
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2610
Mailing Address - Country:US
Mailing Address - Phone:561-801-1233
Mailing Address - Fax:
Practice Address - Street 1:2822 THORNHILL RD APT 272A
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35213-4026
Practice Address - Country:US
Practice Address - Phone:561-801-1233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program