Healthcare Provider Details

I. General information

NPI: 1699063123
Provider Name (Legal Business Name): JOSE IGNACIO RUADES NINFEA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2011
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6767 29TH ST
GREELEY CO
80634-5474
US

IV. Provider business mailing address

6767 29TH ST
GREELEY CO
80634-5474
US

V. Phone/Fax

Practice location:
  • Phone: 970-652-2780
  • Fax: 970-652-2797
Mailing address:
  • Phone: 970-652-2780
  • Fax: 970-652-2797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number61349
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberDR.0070714
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: