Rudeen, Randall L

Rudeen, Randall L is an sole proprietor health care provider with primary practice located at 4424 E Flamingo Ave Suite 200, Nampa ID 83687-9300. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is his primary health care specialty. Rudeen, Randall L can be contacted via phone (208) 288-4888.

Contact Information

Primary practice address
4424 E Flamingo Ave Suite 200 Nampa ID 83687-9300
Phone: (208) 288-4888
Fax: (208) 288-4890
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X M5040 Idaho
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X M-5040 Idaho

Profile Details

NPI number 1396763793
LBN Legal business name Rudeen, Randall L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 17th, 2006
Last updated Dec 10th, 2014 - about 12 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 1396763793 NPPES
Idaho MEDICAID 002648200

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