Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 77458 | MA |
Y | 207PP0204X | Pediatric Emergency Physician | 4301101957 | MI |
NPI | 1104851195 |
---|---|
Provider Name | Ronald Phillip Ruffing |
First Address | Detroit, MI 48201 |
Second Address | Detroit, MI 48201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 15/01/2015 |