Provider Demographics
NPI:1558893891
Name:RUDOFKER, ERIC WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:WILLIAM
Last Name:RUDOFKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-2412
Mailing Address - Fax:970-490-4173
Practice Address - Street 1:175 INVERNESS DR W STE 300
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5069
Practice Address - Country:US
Practice Address - Phone:720-516-9092
Practice Address - Fax:720-516-9093
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0064000207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine