Organization
SURGERY MANAGEMENT SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT L RUDOLPH MD (OWNER)
(304) 424-2102
Entity
Organization
Contact information
Practice address
705 GARFIELD AVE, SUITE 440, PARKERSBURY, WV 26102-0183
(304) 424-2102
(304) 424-2103
Mailing address
PO BOX 183, PARKERSBURG, WV 26102-0183
(304) 424-2102
(304) 424-2103
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
12909
WV
2086S0102X
Surgical Critical Care Physician
12909
WV
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
12909
WV
Other
Enumeration date
02/22/2007
Last updated
08/19/2008
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