Provider Demographics
NPI:1548263965
Name:RUDDEN, ANN M (MD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:M
Last Name:RUDDEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PMB # 287
Mailing Address - Street 2:9611 N.US HIGHWAY 1
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958
Mailing Address - Country:US
Mailing Address - Phone:772-713-6374
Mailing Address - Fax:
Practice Address - Street 1:108 NERANG STREET
Practice Address - Street 2:GOLD COAST HOSPITAL
Practice Address - City:SOUTHPORT
Practice Address - State:QUEENSLAND
Practice Address - Zip Code:4215
Practice Address - Country:AU
Practice Address - Phone:5-571-8211
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL90005207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB37067Medicare UPIN