| David Rudolph, Md | |
|
561 S Denali St Ste C Palmer AK 99645-6464 | |
| (907) 745-8432 | |
| Not Available |
| Full Name | David Rudolph, Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 561 S Denali St Ste C, Palmer, Alaska |
| Authorized Official Name and Position | David S Rudolph (OWNER) |
| Authorized Official Contact | 9077458432 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David Rudolph, Md 561 S Denali St Ste C Palmer AK 99645-6464 Ph: (907) 745-8432 | David Rudolph, Md 561 S Denali St Ste C Palmer AK 99645-6464 Ph: (907) 745-8432 |
| NPI Number | 1457775520 |
|---|---|
| Provider Enumeration Date | 02/10/2014 |
| Last Update Date | 02/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457775520 | NPI | - | NPPES |
| 1011028 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD2033 (Alaska) | Primary |
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