Healthcare Provider Details

I. General information

NPI: 1851486542
Provider Name (Legal Business Name): ANDREW RUDINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 04/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 TURTLE CREEK DR
ASHEVILLE NC
28803-3152
US

IV. Provider business mailing address

PO BOX 1869
FLETCHER NC
28732-1869
US

V. Phone/Fax

Practice location:
  • Phone: 828-274-4555
  • Fax: 828-274-8348
Mailing address:
  • Phone: 828-687-6282
  • Fax: 828-650-8076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number9700756
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number9700756
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: