Rudder, Michiel Brent
Rudder, Michiel Brent is an individual health care provider with primary practice located at 622 West Market Street , Bolivar TN 38008. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Rudder, Michiel Brent can be contacted via phone (731) 658-4500.Contact Information
Primary practice address
622 West Market Street
Bolivar TN 38008
Phone: (731) 658-4500
Fax: (731) 658-4545
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | RN131561 | Tennessee |
Profile Details
| NPI number | 1841287109 |
|---|---|
| LBN Legal business name | Rudder, Michiel Brent |
| Credentials | FNP MSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 3rd, 2005 |
| Last updated | Mar 7th, 2023 - about 3 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 | 1841287109 | NPPES |
| Tennessee | MEDICAID | 3909409 |
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