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Individual

DR. RUDOLPH MICHAEL KEVAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 MAIN ST, SAINT ALBANS, WV 25177-2802
(304) 201-3600
(304) 201-2368
Mailing address
200 MAIN ST, SAINT ALBANS, WV 25177-2802
(304) 201-3600
(304) 201-2368

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
18988
WV
207R00000X
Internal Medicine Physician
Primary
18988
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5600010-000
WV
Enumeration date
07/19/2005
Last updated
04/20/2011
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