Provider Demographics
NPI:1700318730
Name:CORDEIRO-RUDNISKY, FERNANDA CAROLINA GODOI (MD)
Entity type:Individual
Prefix:MRS
First Name:FERNANDA CAROLINA
Middle Name:GODOI
Last Name:CORDEIRO-RUDNISKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:FERNANDA CAROLINA
Other - Middle Name:GODOI
Other - Last Name:CORDEIRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3621 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1633
Mailing Address - Country:US
Mailing Address - Phone:734-647-5299
Mailing Address - Fax:
Practice Address - Street 1:1500 E MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5000
Practice Address - Country:US
Practice Address - Phone:734-936-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301503598207ZC0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology