Provider Demographics
NPI:1427093764
Name:VALVERDE HAEUSSLER, RODOLFO JOSE (MD)
Entity type:Individual
Prefix:
First Name:RODOLFO
Middle Name:JOSE
Last Name:VALVERDE HAEUSSLER
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 1:130 HIGHWAY 252
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-5054
Mailing Address - Country:US
Mailing Address - Phone:864-965-9778
Mailing Address - Fax:
Practice Address - Street 1:130 HIGHWAY 252
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-5054
Practice Address - Country:US
Practice Address - Phone:864-965-9778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC278162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC278167Medicaid
SC278167Medicaid
SCI34874Medicare UPIN
SCAA09673361Medicare PIN