Individual
MR. RUDOLPH EDWARD JENKINS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 BROWN ST, CHESTERTOWN, MD 21620-1435
(410) 778-3300
Mailing address
100 BROWN ST, CHESTERTOWN, MD 21620-1435
(410) 778-3300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0002767
MD
363AS0400X
Surgical Physician Assistant
C5-0000654
DE
Other
Enumeration date
10/20/2006
Last updated
10/28/2011
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