Provider Demographics
NPI:1740253962
Name:RUDD, REBECCA A (MD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:A
Last Name:RUDD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:603 STANWIX ST
Mailing Address - Street 2:SUITE 500 GATEWAY CENTER
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-1451
Mailing Address - Country:US
Mailing Address - Phone:412-288-2130
Mailing Address - Fax:
Practice Address - Street 1:99 AUTUMN ST
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-1301
Practice Address - Country:US
Practice Address - Phone:724-375-8147
Practice Address - Fax:724-375-2435
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD461633207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP514395OtherOXFORD
NJ080172910OtherRAILROAD MEDICARE
NJ223360408-053OtherQUALCARE
NJ2316901Medicaid
NJ1K8539OtherHEALTHNET
NJP514395OtherOXFORD
NJ223360408-053OtherQUALCARE