Individual
RHYS RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1818 CAREW ST, SUITE 210, FORT WAYNE, IN 46805-4788
(260) 482-8681
(260) 373-4699
Mailing address
1234 E DUPONT RD, SUITE 1, FORT WAYNE, IN 46825-1545
(260) 373-9700
(260) 373-9740
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01029545
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000633802
ANTHEM
IN
05
—
100338370
—
IN
01
—
P00803483
R.R. MEDICARE
IN
Enumeration date
08/11/2006
Last updated
03/23/2013
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