1861477085

Everything you always wanted to know about RUDOLPH GERRIT DANIEL MD but were afraid to ask.

RUDOLPH GERRIT DANIEL MD

You can also download the this 1861477085 data report as csv | excel | json | xml
Provider Last Name Provider Middle Name Provider First Name Provider Credential
RUDOLPH GERRIT DANIEL MD
Gender:
Male
Enumeration date:
2005-12-09
Last update date:
2014-02-07
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state
203936901 Medicaid none MO

Taxonomies

Taxonomy State License Number Primary?
208000000X Pediatrics MO 105323 Y

Phone Numbers

Type Number
Mailing Address Telephone Number 6369334141
Practice Location Address Telephone Number 6369334141
Mailing Address Fax Number 6369317007
Practice Location Address Fax Number 6369317007

Addresses

Type Address City State Postal Country
Mailing Address 35 GOODWIN DRIVE FESTUS MO 63028 MO
Practice Location Address 35 GOODWIN DR FESTUS MO 0 MO

Other NPI Records that share a phone number

NPI Name Address State City
1013992189 BOLDT, JOSHUA
Individual
35 GOODWIN DR MO FESTUS
1104215086 JADWISIAK, LOUISE
Individual
35 GOODWIN DR MO FESTUS
1114478120 RUDOLPH, SEAN
Individual
35 GOODWIN DR MO FESTUS
1457336166 DONOVAN, ERIN
Individual
35 GOODWIN DR MO FESTUS
1477063253 REESE, ASHLEY
Individual
35 GOODWIN DR MO FESTUS
1487857033 CCPARTNERS LLC
Organization
35 GOODWIN DR MO FESTUS
1558560961 BESS, PETER
Individual
35 GOODWIN DR MO FESTUS
1659356731 APPELBAUM, NORA
Individual
1400 HIGHWAY 61 SOUTH MO FESTUS
1659889244 BROWN, MICHELLE
Individual
35 GOODWIN DR MO FESTUS

Other NPI Records that share an address

NPI Name Address State City
1013992189 BOLDT, JOSHUA
Individual
35 GOODWIN DR MO FESTUS
1104215086 JADWISIAK, LOUISE
Individual
35 GOODWIN DR MO FESTUS
1114478120 RUDOLPH, SEAN
Individual
35 GOODWIN DR MO FESTUS
1457336166 DONOVAN, ERIN
Individual
35 GOODWIN DR MO FESTUS
1477063253 REESE, ASHLEY
Individual
35 GOODWIN DR MO FESTUS
1487857033 CCPARTNERS LLC
Organization
35 GOODWIN DR MO FESTUS
1558560961 BESS, PETER
Individual
35 GOODWIN DR MO FESTUS
1659889244 BROWN, MICHELLE
Individual
35 GOODWIN DR MO FESTUS