Rudnick, Laurie Jean

Rudnick, Laurie Jean is an individual health care provider with primary practice located at 19901 E 10 Mile Rd , Saint Clair Shores MI 48080-1069. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Rudnick, Laurie Jean can be contacted via phone (586) 777-1277.

Contact Information

Primary practice address
19901 E 10 Mile Rd Saint Clair Shores MI 48080-1069
Phone: (586) 777-1277
Fax: (586) 777-0106
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301066008 Michigan

Profile Details

NPI number 1407822612
LBN Legal business name Rudnick, Laurie Jean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated Sep 28th, 2011 - about 15 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 1407822612 NPPES
Michigan Other 0P27380 MEDICARE GROUP LEGACY #
Michigan Other 700E031610 MEDICARE GROUP LEGACY #
Michigan MEDICAID 4828442 MEDICARE GROUP LEGACY #

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