Beverly-Rudisel, Nettie Yvette
Beverly-Rudisel, Nettie Yvette is an individual health care provider with primary practice located at 1401 Matthews Township Pkwy Suite 200, Matthews NC 28105-5402. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Beverly-Rudisel, Nettie Yvette can be contacted via phone (704) 384-6901.Contact Information
Primary practice address
1401 Matthews Township Pkwy Suite 200
Matthews NC 28105-5402
Phone: (704) 384-6901
Fax: (704) 384-6902
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 33943 | North Carolina |
Profile Details
| NPI number | 1598747388 |
|---|---|
| LBN Legal business name | Beverly-Rudisel, Nettie Yvette |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 17th, 2005 |
| Last updated | Oct 28th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598747388 | NPPES |
| South Carolina | MEDICAID | N33943 | |
| South Carolina | MEDICAID | 8973843 |
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