Individual
DR. RODOLFO M MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2907 PLEASANT VALLEY BLVD, ALTOONA, PA 16602-4305
(814) 943-8164
(814) 940-7887
Mailing address
2907 PLEASANT VALLEY BLVD, ALTOONA, PA 16602-4305
(814) 943-8164
(814) 940-7887
Taxonomy
Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary
MD026330E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0980619
—
PA
Enumeration date
07/20/2006
Last updated
07/08/2007
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