Healthcare Provider Details

I. General information

NPI: 1013207067
Provider Name (Legal Business Name): HILJA REBECCA RUEGG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HILJA REBECCA TERRY

II. Dates (important events)

Enumeration Date: 04/12/2011
Last Update Date: 09/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST PSYCHIATRY
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

234 GOODMAN ST PSYCHIATRY
CINCINNATI OH
45219-2364
US

V. Phone/Fax

Practice location:
  • Phone: 513-558-7700
  • Fax:
Mailing address:
  • Phone: 513-558-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.123856
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35 123856
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: