Rudolph, Teresa L
Rudolph, Teresa L is an individual health care provider with primary practice located at 1504 S Commercial St , Neenah WI 54956-4802. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Rudolph, Teresa L can be contacted via phone (920) 729-6088.Contact Information
Primary practice address
1504 S Commercial St
Neenah WI 54956-4802
Phone: (920) 729-6088
Fax: (920) 729-6484
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 31387 | Wisconsin |
Profile Details
| NPI number | 1104869379 |
|---|---|
| LBN Legal business name | Rudolph, Teresa L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2006 |
| Last updated | Apr 14th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104869379 | NPPES |
| Wisconsin | MEDICAID | 31670900 |
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