Rudolph, Lance A.
Rudolph, Lance A. is an individual health care provider with primary practice located at 300 Oak St Ne , Albuquerque NM 87106-4725. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Rudolph, Lance A. can be contacted via phone (505) 855-5525.Contact Information
Primary practice address
300 Oak St Ne
Albuquerque NM 87106-4725
Phone: (505) 855-5525
Fax: (505) 884-4006
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 83-104 | New Mexico |
Profile Details
| NPI number | 1376502997 |
|---|---|
| LBN Legal business name | Rudolph, Lance A. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 22nd, 2006 |
| Last updated | Jan 31st, 2008 - about 16 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 | 1376502997 | NPPES |
| New Mexico | MEDICAID | 000Z5691 | |
| New Mexico | Other | NM004414 | |
| New Mexico | MEDICAID | 000-16667 |
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