Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 8337 | NC |
NPI | 1083757298 |
---|---|
Provider Name | Andrew T Ruvo |
First Address | Durham, NC 27704-2621 |
Second Address | Durham, NC 27704-2621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 08/07/2007 |