Provider Demographics
NPI:1326136235
Name:RUDOY, RAUL C (MD)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:C
Last Name:RUDOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 PUNAHOU ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1001
Mailing Address - Country:US
Mailing Address - Phone:808-983-8387
Mailing Address - Fax:808-945-1570
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-983-8387
Practice Address - Fax:808-945-1570
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-26142080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIE80742Medicare UPIN