Individual
LAWRENCE ANDREW RUDOLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 CALVARY CHURCH RD STE B, FESTUS, MO 63028-4125
(636) 933-2900
(636) 933-8017
Mailing address
1500 CALVARY CHURCH RD STE B, FESTUS, MO 63028-4125
(636) 933-2900
(636) 933-8017
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2020041808
MO
Other
Enumeration date
06/18/2018
Last updated
07/22/2021
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