Basic Information
| Provider Information | |||||||||
| NPI: | 1891838504 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUDNIK | ||||||||
| FirstName: | VOLHA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 ELTON HILLS DR NW # 3 | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | MN | ||||||||
| PostalCode: | 559013555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5075296616 | ||||||||
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| Practice Location | |||||||||
| Address1: | 120 ELTON HILLS DR NW # 3 | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | MN | ||||||||
| PostalCode: | 559013555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5075296616 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2007 | ||||||||
| LastUpdateDate: | 01/29/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208000000X | 53977 | MN | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.