Healthcare Provider Details

I. General information

NPI: 1770599508
Provider Name (Legal Business Name): PRISCILLA RUHE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 04/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 E UNIVERSITY AVE SUITE 200
PLEASANT HILL IA
50327-8457
US

IV. Provider business mailing address

PO BOX 1475
DES MOINES IA
50305-1475
US

V. Phone/Fax

Practice location:
  • Phone: 515-643-2400
  • Fax: 515-643-4766
Mailing address:
  • Phone: 515-643-2400
  • Fax: 515-643-4766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number29846
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: