Basic Information
| Provider Information | |||||||||
| NPI: | 1801946595 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARE | ||||||||
| FirstName: | RUDD | ||||||||
| MiddleName: | JUDSON | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2562 7TH ST | ||||||||
| Address2: | |||||||||
| City: | CUYAHOGA FALLS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442212406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303285473 | ||||||||
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| Practice Location | |||||||||
| Address1: | 272 BENEDICT AVE | ||||||||
| Address2: | FISHER-TITUS MEDICAL CENTER | ||||||||
| City: | NORWALK | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448572374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8005893862 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 35088449 | OH | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.