Mathieu, Owen Rudolph
Mathieu, Owen Rudolph is an sole proprietor health care provider with primary practice located at 100 Highland Ave Suite 202, Salem MA 01970-2702. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Mathieu, Owen Rudolph can be contacted via phone (978) 740-0634.Contact Information
Primary practice address
100 Highland Ave Suite 202
Salem MA 01970-2702
Phone: (978) 740-0634
Fax: (978) 740-0636
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 36892 | Massachusetts |
Profile Details
| NPI number | 1881750982 |
|---|---|
| LBN Legal business name | Mathieu, Owen Rudolph |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 31st, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1881750982 | NPPES |
| Massachusetts | MEDICAID | 2027496 |
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