Fred Louis Rudman, D.D.S.
Individual provider Active NPI Dentist · Middletown, MD
NPI 1316218977 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1316218977
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 7537 (MD)
- Practice address
- 807 E Main St
Middletown, MD 21769-7722 - Phone
- (301) 293-6828
- Fax
- (301) 371-4989
- NPI assigned
- Jan 13, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7537 | MD | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7537 | MD | Yes |
Addresses
Primary practice location
807 E Main St
Middletown, MD 21769-7722
Mailing address
11643 Meeting House Rd
Myersville, MD 21773-8905
Phone (301) 293-6828
Other providers in Middletown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.