Individual
DR. MICHAEL EDWARD RUDISILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1250 MIRA MAR AVE, MEDFORD, OR 97504-5520
(541) 857-7133
Mailing address
1250 MIRA MAR AVE, MEDFORD, OR 97504-5520
(541) 857-7133
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD27199
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770568933
NPI
OR
Enumeration date
12/09/2005
Last updated
02/29/2012
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