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Individual

KENNETH H RUDOLPH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
802 JEFFERSON AVE, SCRANTON, PA 18510-1038
(570) 343-3999
(570) 343-2749
Mailing address
802 JEFFERSON AVE, SCRANTON, PA 18510
(570) 343-3999
(570) 343-2749

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD021263E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000609340
PA
Enumeration date
01/13/2006
Last updated
06/13/2008
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