Individual
DR. PRIYA RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
125 KING AVE, SUITE 200, ATHENS, GA 30606-6734
(706) 369-4478
(706) 353-6639
Mailing address
1835 SAVOY DR, SUITE 300, ATLANTA, GA 30341-1072
(706) 369-4478
(706) 353-6639
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
068852
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003129225B
—
GA
05
—
003129225C
—
GA
01
—
P01155926
RR MEDICARE
GA
Enumeration date
09/01/2005
Last updated
10/25/2022
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