Healthcare Provider Details

I. General information

NPI: 1639399496
Provider Name (Legal Business Name): ELIZABETH MARY RUFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 S CENTER ST
WESTMINSTER MD
21157-5219
US

IV. Provider business mailing address

290 S CENTER ST
WESTMINSTER MD
21157-5219
US

V. Phone/Fax

Practice location:
  • Phone: 410-876-4927
  • Fax: 410-876-4959
Mailing address:
  • Phone: 410-876-4927
  • Fax: 410-876-4959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0016213
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: