Provider Demographics
NPI:1962576108
Name:RUMMLER, RANDY ORD (MD)
Entity type:Individual
Prefix:DR
First Name:RANDY
Middle Name:ORD
Last Name:RUMMLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 E STEIN HWY
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-1416
Mailing Address - Country:US
Mailing Address - Phone:302-628-1549
Mailing Address - Fax:302-628-9043
Practice Address - Street 1:306 E STEIN HWY
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-1416
Practice Address - Country:US
Practice Address - Phone:302-628-1549
Practice Address - Fax:302-628-9043
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC100038902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEF29227Medicare UPIN