Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 164617 | NC |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 036.140430 | IL |
NPI | 1326366048 |
---|---|
Provider Name | Dr. Michael Ruffolo |
First Address | Raleigh, NC 27604-0010 |
Second Address | Raleigh, NC 27610-1214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2010 |
Last Update Date | 08/04/2021 |