Individual
RANDALL ALLEN RUPPEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
Mailing address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101251186
VA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
0101251186
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200363710
—
IN
Enumeration date
12/05/2005
Last updated
03/28/2016
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