Healthcare Provider Details

I. General information

NPI: 1134945025
Provider Name (Legal Business Name): RUBY FRAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RUBY LOVASZ PA-C

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 S WASHINGTON AVE
SAGINAW MI
48601-2556
US

IV. Provider business mailing address

4000 WELLNESS DR
MIDLAND MI
48670-2000
US

V. Phone/Fax

Practice location:
  • Phone: 989-754-3000
  • Fax:
Mailing address:
  • Phone: 844-832-1956
  • Fax: 989-633-5241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601013234
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: