Santoso, Rudy A.

Santoso, Rudy A. is an sole proprietor health care provider with primary practice located at 327 1St Ave Nw , Hickory NC 28601-6122. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Santoso, Rudy A. can be contacted via phone (828) 695-5900.

Contact Information

Primary practice address
327 1St Ave Nw Hickory NC 28601-6122
Phone: (828) 695-5900
Fax: (828) 695-4256
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 26148 North Carolina

Profile Details

NPI number 1023128287
LBN Legal business name Santoso, Rudy A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 30th, 2006
Last updated Mar 7th, 2023 - about 2 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 1023128287 NPPES
North Carolina Other 74543 BCBS
North Carolina Other 183254 BCBS
North Carolina Other 259250000 BCBS
North Carolina MEDICAID 7974543 BCBS

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