Rudolph, Carla

Rudolph, Carla is an individual health care provider with primary practice located at 1851 Old Us 66 , Edgewood NM 87015-7200. She recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as her primary health care specialty. Rudolph, Carla can be contacted via phone (505) 286-2396.

Contact Information

Primary practice address
1851 Old Us 66 Edgewood NM 87015-7200
Phone: (505) 286-2396
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X A-1770-13 New Mexico

Profile Details

NPI number 1104182328
LBN Legal business name Rudolph, Carla
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 2nd, 2012
Last updated May 4th, 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 1104182328 NPPES
North Carolina MEDICAID 1104182328

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