=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851486542
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANDREW RUDINS MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2006
-----------------------------------------------------
Last Update Date | 04/07/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 21 TURTLE CREEK DR
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28803-3152
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-274-4555
-----------------------------------------------------
Fax | 828-274-8348
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1869
-----------------------------------------------------
City | FLETCHER
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28732-1869
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-687-6282
-----------------------------------------------------
Fax | 828-650-8076
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2081S0010X
-----------------------------------------------------
Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
-----------------------------------------------------
License Number | 9700756
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | 9700756
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------