Healthcare Provider Details

I. General information

NPI: 1578622098
Provider Name (Legal Business Name): MICHELE LYNN RUATTO AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 05/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30055 NORTHWESTERN HWY SUITE #101
FARMINGTON HILLS MI
48334-3230
US

IV. Provider business mailing address

30055 NORTHWESTERN HWY STE 101
FARMINGTON HILLS MI
48334-3260
US

V. Phone/Fax

Practice location:
  • Phone: 248-865-4166
  • Fax: 248-865-4198
Mailing address:
  • Phone: 586-226-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number3501002934
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: