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General NPI Number Information
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NPI Number | 1619174307
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Entity Type | Individual
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Provider Name | SHARON EVONNE RUCH M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 11/03/2019
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Provider Practice Location Address
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Address Line | 10620 SOUTHERN HIGHLANDS PARKWAY STE 110-155
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City | LAS VEGAS
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State | NV
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Zip | 89141
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Country | US
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Telephone | 702-754-5421
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Fax | 775-312-2857
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Provider Business Mailing Address
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Address Line | 10620 S HIGHLANDS PKY STE 110 155
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City | LAS VEGAS
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State | NV
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Zip | 89141
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Country | US
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Telephone | 702-754-5421
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Fax | 775-312-2857
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 12553
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License Number State | NV
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