Individual
MARK ALLEN RUDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 255-6480
Mailing address
5732 EAGLE CT, ST CLOUD, MN 56303
(320) 240-2344
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9672
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
443919800
—
MN
Enumeration date
02/16/2006
Last updated
12/22/2009
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