RANDAL H. RUDDERMAN MD INC (NPI# 1609175421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1609175421 |
Entity Type | Organization |
Organization Name | RANDAL H. RUDDERMAN MD INC |
Practice Address |
3400-c Old Milton Pkwy, Ste 450 Alpharetta GA 30005-3707 |
Practice Telephone | 6785667200 |
Practice Fax Number | 6785667210 |
Mailing Telephone | 6785667200 |
Mailing Fax Number | 6785667210 |
Enumeration Date | 2011-03-18 |
Last Update Date | 2015-06-22 |
Authorized Official Name | RANDAL RUDDERMAN (PRESIDENT) |
Authorized Official Telephone | 6785667200 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
024863 | GA | Allopathic & Osteopathic Physicians |
Street Address |
3400-C OLD MILTON PKWY, STE 450 |
City | ALPHARETTA |
State | GA |
Zip Code | 30005-3707 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922615483 | Amarrah Shatia Guyton | Behavior Technician | 6505 Shiloh Point Road, Alpharetta, GA 30005 | 2020-09-29 |
1396351771 | Stephanie Hightower | Behavior Technician | 6505 Shiloh Pt Rd, Alpharetta, GA 30005 | 2020-09-21 |
1689130874 | Optima Eye Care LLC | Optometrist | 6365 Halcyon Way, Suite 935, Alpharetta, GA 30005 | 2019-02-13 |
1275006652 | Ariel Kaitlyn Petrakovich | Behavioral Analyst | 6505 Shiloh Road, Suite 100, Alpharetta, GA 30005 | 2019-01-08 |
1003306515 | Brightview Pharmacy, LLC | Pharmacy | 3333 Old Milton Pkwy Ste 130, Alpharetta, GA 30005 | 2018-05-10 |
1316452600 | Kara Marie Arps | Physical Therapist | 855 Yearling Chase, Alpharetta, GA 30005 | 2017-12-08 |
1417468307 | Paige Biringer | Physical Therapist | 6495 Shiloh Rd Ste 100, Alpharetta, GA 30005 | 2017-10-18 |
1528587169 | Laura Kinney Pearce | Speech-Language Pathologist | 6505 Shiloh Rd #100, Alpharetta, GA 30005 | 2017-09-14 |
1629526678 | Samantha Menton | Chiropractor | 11875 Jones Bridge Road, Suite A, Alpharetta, GA 30005 | 2016-09-20 |
1427424183 | Trek Medical, LLC | Clinic/Center | 5895 Windward Parkway, Suite 150, Alpharetta, GA 30005 | 2015-08-18 |
Find all providers in zip 30005 |
Taxonomy Code | 2086S0122X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Plastic and Reconstructive Surgery |
A surgeon who specializes in plastic and reconstructive surgery. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427668342 | Spa Medical LLC | Surgery | 455 Plum St, Macon, GA 31201-3368 | 2020-08-05 |
1356972848 | North Atlanta Plastic Surgery Group LLC | Surgery | 11877 Douglas Rd Ste 102-367, Johns Creek, GA 30005-4325 | 2020-02-03 |
1881100337 | Rpc Employee Services, LLC | Surgery | 975 Johnson Ferry Rd Ste 100, Atlanta, GA 30342-1618 | 2017-12-20 |
1093255044 | Southeastern Aesthetic and Reconstructive Surgery | Surgery | 155 Greenville St, Newnan, GA 30263-2630 | 2017-02-24 |
1700249042 | Justin Kyle Williams | Surgery | 3200 Downwood Cir Nw Ste 640-4, Atlanta, GA 30327-1610 | 2016-04-04 |
1871901009 | Southeastern Reconstructive Services LLC | Surgery | 5205 Frederick St Ste B, Savannah, GA 31405-4520 | 2014-07-31 |
1730479452 | Olumayowa Pitan Abiodun | Surgery | 2709 Meredyth Dr Ste 340, Albany, GA 31707 | 2011-04-14 |
1033374392 | James Bradford Depew | Surgery | 120 Vann St Ne Ste 150, Marietta, GA 30060 | 2008-07-25 |
1255591814 | Corey Patrick Harkins | Surgery | 120 Vann Street, Suite 150, Marietta, GA 30060 | 2008-06-16 |
1235313776 | Robert William Crow | Surgery | 4400 Harris Valley Rd Nw, Atlanta, GA 30327-3828 | 2007-12-19 |
Find all providers with the same taxonomy |
City | ALPHARETTA |
Zip Code | 30005 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.