Healthcare Provider Details

I. General information

NPI: 1104211036
Provider Name (Legal Business Name): RUDOLF BURCL M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2015
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST UNIVERSITY OF CINCINNATI MEDICAL CENTER
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

DEPARTMENT OF ANESTHESIOLOGY 231 ALBERT SABIN WAY
CINCINNATI OH
45267-0531
US

V. Phone/Fax

Practice location:
  • Phone: 513-584-1000
  • Fax:
Mailing address:
  • Phone: 513-558-6356
  • Fax: 513-558-0995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number57.025867
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: