Individual
DAVID SAMUEL RUDOLPH
Active
Individual
DAVID SAMUEL RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS014560
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037276
MLHC GROUP AA #
PA
01
—
1922077643
MLHC GROUP NPI #
PA
01
—
440771
MLHC MEDICARE AA#
PA
01
—
824305
BS AA#
PA
01
—
OS14560
PA MEDICAL LICENSE #
—
Enumeration date
04/02/2009
Last updated
10/13/2014
Update your record
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