Rudolph, Mary M

Rudolph, Mary M is an individual health care provider with primary practice located at 321 Middlefield Rd , Menlo Park CA 94025-3500. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, which is considered as her primary health care specialty. Rudolph, Mary M can be contacted via phone (650) 498-6623.

Contact Information

Primary practice address
321 Middlefield Rd Menlo Park CA 94025-3500
Phone: (650) 498-6623
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X NP572 California

Profile Details

NPI number 1588628218
LBN Legal business name Rudolph, Mary M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 12th, 2006
Last updated Dec 20th, 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 1588628218 NPPES
Other MMM00087M NHIC

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