Rudolph, Michael Bennett

Rudolph, Michael Bennett is an individual health care provider with primary practice located at 300 Seaside Ave , Milford CT 06460-4603. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Rudolph, Michael Bennett can be contacted via phone (203) 876-4000.

Contact Information

Primary practice address
300 Seaside Ave Milford CT 06460-4603
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 035390 Connecticut

Profile Details

NPI number 1700999000
LBN Legal business name Rudolph, Michael Bennett
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2006
Last updated Jun 7th, 2019 - 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 1700999000 NPPES
Connecticut MEDICAID 001353903

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