Elizabeth Rudenberg, DO
Individual provider Active NPI Family Medicine Physician · Richmond, ME
NPI 1720350549 · NPPES record last updated Feb 9, 2012
Key facts
- NPI
- 1720350549
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 1382 (ME)
- Practice address
- 24 Gardiner St
Richmond, ME 04357 - Phone
- (207) 737-4359
- Fax
- (207) 737-4412
- NPI assigned
- Feb 9, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1382 | ME | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1382 | ME | Yes |
Addresses
Primary practice location
24 Gardiner St
Richmond, ME 04357
Mailing address
24 Gardiner St
Richmond, ME 04357
Phone (207) 737-4359
Other providers in Richmond, ME
- Naba Homecare
- Corry McMullen Pelsor
- RFC Maine P.C.
- Richmond Eldercare Coalition
- Richmond School Department
- Cheryl Lynne Skilling
- Smile4Me Dental Hygiene
- Agnieszka Smith
- Brianne Snow
- Tide & Timber Nursing Services LLC
All providers in Richmond, ME · Family Medicine Physician in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2012. 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.