Individual
DR. MICHAEL RUNDLETT
Active
Individual
DR. MICHAEL RUNDLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4877
MA
103TH0100X
Health Service Psychologist
4877
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020923
VALUE OPTIONS PROVIDER NU
MA
01
—
110251000
MAGELLAN PROVIDER NUMBER
MA
01
—
6192642
EVERCARE PROVIDER NUMBER
MA
01
—
W04645
BCBS PROVIDER NUMBER
MA
Enumeration date
10/16/2006
Last updated
03/08/2010
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