Active NPI
Richard M Dudzik, CRNA
- Certified Registered Nurse Anesthetist
- Midland, MI
National Provider Identifier
1013007749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 4704109065
- Practice address
- 4005 Orchard Dr
Midland, MI 48670-0001 - Phone
- (989) 839-3000
- NPI assigned
- Oct 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 4704109065 | MI | Primary |
Addresses
Primary practice location
4005 Orchard Dr
Midland, MI 48670-0001
Mailing address
3884 E Old Pine TRL
Midland, MI 48642-8864
Phone (989) 832-9825
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598984 | Medicaid | MI | |
| RD109065 | Other | MI | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704109065 | MI | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1013007749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3884 E OLD PINE TRL",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486428864",
"telephone_number": "989-832-9825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4005 ORCHARD DR",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486700001",
"telephone_number": "989-839-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDZIK",
"first_name": "RICHARD",
"middle_name": "M",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MI",
"license": "4704109065",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1598984",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "RD109065",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Midland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.