Anderson, Rudolph Clinton

Anderson, Rudolph Clinton is an sole proprietor health care provider with primary practice located at 1600 N Beauregard St Ste 300 , Alexandria VA 22311-1732. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Anderson, Rudolph Clinton can be contacted via phone (703) 940-3810.

Contact Information

Primary practice address
1600 N Beauregard St Ste 300 Alexandria VA 22311-1732
Phone: (703) 940-3810
Fax: (703) 940-3811
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 0103001041 Virginia

Profile Details

NPI number 1275526501
LBN Legal business name Anderson, Rudolph Clinton
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 23rd, 2005
Last updated Dec 30th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275526501 NPPES
Virginia MEDICAID 9304240

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