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General NPI Number Information
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NPI Number | 1023482965
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Entity Type | Organization
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Legal Business Name | RUETZEL GYNECOLOGY & OBSTETRICS
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Dates
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Enumeration Date | 11/16/2015
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Last Update Date | 02/19/2016
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Provider Practice Location Address
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Address Line | 824 GREENBRIER PKWY STE 100
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City | CHESAPEAKE
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State | VA
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Zip | 23320-3697
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Country | US
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Telephone | 757-410-7390
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Fax | 757-410-7395
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Provider Business Mailing Address
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Address Line | 824 GREENBRIER PKWY STE 100
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City | CHESAPEAKE
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State | VA
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Zip | 23320-3697
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Country | US
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Telephone | 757-410-7390
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Fax | 757-410-7395
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Authorized Official
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Title or Position | OWNER
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Name | DR. CRAIG H RUETZEL
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Credential | MD
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Telephone | 757-410-7390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101048262
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License Number State | VA
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