Rudolph, Ivan
Rudolph, Ivan is an individual health care provider with primary practice located at 132 S 10Th St 480 Main Building, Phila PA 19107-5244. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Rudolph, Ivan can be contacted via phone (215) 955-8900.Contact Information
Primary practice address
132 S 10Th St 480 Main Building
Phila PA 19107-5244
Phone: (215) 955-8900
Fax: (215) 955-5245
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | MD006250E | Pennsylvania |
Profile Details
| NPI number | 1053371930 |
|---|---|
| LBN Legal business name | Rudolph, Ivan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 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 | 1053371930 | NPPES |
| Pennsylvania | MEDICAID | 0017270520003 |
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