MEDICARE: DR. ANDREW HINKLEY RUZICH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	MD058699L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001695766	OTHER	PA	HIGHMARK
2	206789	OTHER	PA	UPMC
3	10935378	OTHER	PA	CAQH
4	3815115	OTHER	PA	AETNA
5	1500039	OTHER	PA	GATEWAY
6	258371	OTHER	PA	HEALTH ASSUR/ADVANTRA

General Provider Information

NPI Number	:	1124013180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW HINKLEY RUZICH M.D.

Provider Business Mailing Address
First Line	:	236 W ALLEGHENY RD
Second Line	:
City	:	IMPERIAL
State	:	PA
Zip	:	15126-9775
Country	:	US
Telephone Number	:	724-695-3371
Fax Number	:	724-695-3372

Provider Business Practice Location Address
First Line	:	236 W ALLEGHENY RD
Second Line	:
City	:	IMPERIAL
State	:	PA
Zip	:	15126-9775
Country	:	US
Telephone Number	:	724-695-3371
Fax Number	:	724-695-3372

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	03/20/2014

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