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General NPI Number Information
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NPI Number | 1265624167
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Entity Type | Individual
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Provider Name | MICHAEL R RUTLEDGE MD
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Gender | Male
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 12/01/2022
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Provider Practice Location Address
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Address Line | 221 MAHALANI ST
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City | WAILUKU
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State | HI
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Zip | 96793-2526
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Country | US
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Telephone | 808-244-9056
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Fax |
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Provider Business Mailing Address
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Address Line | 221 MAHALANI ST
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City | WAILUKU
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State | HI
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Zip | 96793-2526
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Country | US
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Telephone | 808-244-9056
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Fax | 770-474-8510
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | C166106
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 072449
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | N2272
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 17861
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License Number State | ND
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Taxonomy #5
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 76742-20
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License Number State | WI
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Taxonomy #6
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD-21985
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License Number State | HI
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Taxonomy #7
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME154886
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License Number State | FL
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