Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 77643 | GA |
NPI | 1043260672 |
---|---|
Provider Name | Kathleen Ruffing May |
First Address | Augusta, GA 30912-2828 |
Second Address | Augusta, GA 30912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 31/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BM4779457 | DEA (01) | GA |
G15921 | (02) | MD |