Organization
SOUTH SUBURBAN EAR, NOSE & THROAT ASSOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID B RUDOLPH MD (PRESIDENT)
(781) 337-7635
Entity
Organization
Contact information
Practice address
825 MAIN ST, SOUTH WEYMOUTH, MA 02190-1659
(781) 337-3424
(781) 337-7569
Mailing address
825 MAIN ST, SOUTH WEYMOUTH, MA 02190-1659
(781) 337-3424
(781) 337-7569
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9709517
—
MA
Enumeration date
08/30/2006
Last updated
03/07/2008
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