Individual
LOU RUDOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0100
(801) 581-7553
Mailing address
PO BOX 413025, SALT LAKE CITY, UT 84141-3025
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
7298607-1205
UT
2085R0202X
Diagnostic Radiology Physician
7655
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00714769
RAILROAD MEDICARE
UT
Enumeration date
02/08/2007
Last updated
09/23/2013
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