Robert I Rudolph, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD-013472E Issued in PA

Practice address

1134 Penn Ave
Wyomissing, PA 19610-2034

Phone

(610) 374-4463

NPI assigned

Mar 7, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Robert I. Rudolph, M.D. LTD

  • Dermatology Physician
  • Wyomissing, PA
  • NPI 1851596282
  Authorized official Same address or phone
• Pennsylvania Dermatology Partners Inc

  • Dermatology Physician
  • West Lawn, PA
  • NPI 1023382918
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205971200000",
    "number": "1194856856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 PENN AVE",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 PENN AVE",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102034",
            "telephone_number": "610-374-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "ROBERT",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2008-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD-013472E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew M Rowan, DMD
• Carmen Lee Royall, LPC
• RR Physician Services LLC
• Adam M Rubin, M.D.
• Rachel Rose Rubright
• Danielle Rudy
• Jennifer Ruiz
• Daniel J Runkle
• Teresa Runkle, R.D.
• Jessica A Rupp, M.A.

• Dermatology Physician in Wyomissing, PA
• Providers in Wyomissing, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.