Rudolph, Charles

Rudolph, Charles is an individual health care provider with primary practice located at 170 Mouse Creek Rd Nw , Cleveland TN 37312-3840. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Rudolph, Charles can be contacted via phone (423) 458-1426.

Contact Information

Primary practice address
170 Mouse Creek Rd Nw Cleveland TN 37312-3840
Phone: (423) 458-1426
Fax: (423) 790-1276
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD32155 Tennessee

Profile Details

NPI number 1346351673
LBN Legal business name Rudolph, Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Apr 22nd, 2024 - 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 1346351673 NPPES
Georgia MEDICAID 000931499D
Georgia MEDICAID 3855171
Georgia MEDICAID 00931499A
Georgia MEDICAID 3855172
Georgia Other 3148810
Georgia Other 4150063
Georgia Other P00199940

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