Organization
DAVID RUDOLPH, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID S RUDOLPH MD (OWNER)
(907) 745-8432
Entity
Organization
Contact information
Practice address
561 S DENALI ST STE C, PALMER, AK 99645-6464
(907) 745-8432
Mailing address
561 S DENALI ST STE C, PALMER, AK 99645-6464
(907) 745-8432
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2033
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011028
—
AK
Enumeration date
02/10/2014
Last updated
02/10/2014
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