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General NPI Number Information
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NPI Number | 1295732923
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Entity Type | Individual
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Provider Name | MICHAEL PATRICK RUDOLPH DO
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 305 S STATE ST
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City | ABERDEEN
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State | SD
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Zip | 57401-4527
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Country | US
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Telephone | 605-622-2142
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Fax | 605-622-5127
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Provider Business Mailing Address
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Address Line | PO BOX 9168
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City | MINNEAPOLIS
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State | MN
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Zip | 55480-9168
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Country | US
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Telephone | 866-825-8303
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Fax | 866-582-7105
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 3564
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 02003014A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 35353
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 3564
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License Number State | IA
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Taxonomy #5
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | DO0000001935
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License Number State | TN
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