National Provider Identifier Database

RANDAL H RUDDERMAN MD INC
Plastic and Reconstructive Surgery


Contact Information

RANDAL H. RUDDERMAN MD INC
3400-C OLD MILTON PKWY, STE 450
ALPHARETTA, GA30005-3707
Phone: 678-566-7200
Fax: 678-566-7210
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X

* Indicates primary specialty

NPI Profile & details for RANDAL H. RUDDERMAN MD INC

NPI Number 1609175421
Legal business name
LBN
RANDAL H. RUDDERMAN MD INC
Authorized official RANDAL RUDDERMAN - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 03/18/2011
Last updated 06/22/2015 - About 11 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 024863

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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