Individual
DR. KEVIN M. RUDISEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 MATTHEWS TOWNSHIP PKWY, MATTHEWS, NC 28105-4656
(704) 384-5420
(704) 384-5424
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-5420
(704) 384-5424
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34148
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8973841
—
NC
05
—
N34148
—
SC
Enumeration date
03/14/2006
Last updated
11/02/2011
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