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General NPI Number Information
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NPI Number | 1447200340
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Entity Type | Individual
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Provider Name | MICHAEL RUDMANN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | NATIONAL NAVAL MEDICAL CENTER 8901 WISCONSIN AVE.
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City | BETHESDA
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State | MD
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Zip | 20889-0001
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Country | US
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Telephone | 301-295-0145
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Fax |
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Provider Business Mailing Address
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Address Line | 8555 A SKIP JACK PLACE
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City | PASADENA
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State | MD
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Zip | 21122
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Country | US
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Telephone | 410-437-8496
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 13067
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License Number State | MD
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