Individual
GLEN H RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 E 1ST ST STE 404, DULUTH, MN 55805-2297
(218) 722-5513
(218) 722-6515
Mailing address
1000 E 1ST ST STE 404, DULUTH, MN 55805-2297
(218) 722-5513
(218) 722-6515
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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