Healthcare Provider Details

I. General information

NPI: 1174798276
Provider Name (Legal Business Name): VANESSA RODIS RUALES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UPPER CHESAPEAKE DR
BEL AIR MD
21014-4324
US

IV. Provider business mailing address

4954 VALLEY VIEW OVERLOOK VANRUALES@GMAIL.COM
ELLICOTT CITY MD
21042-2104
US

V. Phone/Fax

Practice location:
  • Phone: 443-643-1000
  • Fax:
Mailing address:
  • Phone: 361-215-1262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD0075724
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: