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Individual
GLEN H RUDOLPH
Active
Individual
GLEN H RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
50713
MN
207X00000X
Orthopaedic Surgery Physician
55776
WI
Other
Enumeration date
07/23/2009
Last updated
03/12/2019
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