MEDICARE: CYNTHIA A RUIZ MD

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	208000000X	Pediatrics Physician	4301068518	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831105006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA A RUIZ MD

Provider Business Mailing Address
First Line	:	3621 S STATE ST
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48108-1633
Country	:	US
Telephone Number	:	734-647-5299
Fax Number	:

Provider Business Practice Location Address
First Line	:	3399 E GRAND RIVER AVE STE 202
Second Line	:
City	:	HOWELL
State	:	MI
Zip	:	48843-7555
Country	:	US
Telephone Number	:	517-548-1020
Fax Number	:

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	11/19/2019

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