David Rudolph, MD

Organization Active NPI Internal Medicine Physician · Palmer, AK

NPI 1457775520 · NPPES record last updated Feb 10, 2014

Key facts

NPI
1457775520
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
License
MD2033 (AK)
Legal business name
DAVID RUDOLPH, MD
Practice address
561 S Denali St Ste C
Palmer, AK 99645-6464
Phone
(907) 745-8432
NPI assigned
Feb 10, 2014
Organization subpart
No

Authorized official

Name
Dr. David S Rudolph, MD
Title
Owner
Phone
(907) 745-8432

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207R00000X MD2033 AK Yes

Addresses

Primary practice location

561 S Denali St Ste C
Palmer, AK 99645-6464

Mailing address

561 S Denali St Ste C
Palmer, AK 99645-6464
Phone (907) 745-8432

Other identifiers

IdentifierTypeStateIssuer
1011028MedicaidAK

Other providers in Palmer, AK

All providers in Palmer, AK · Internal Medicine Physician in Alaska

Sources for this page

Verify at the official NPI Registry.