MEDICARE: DR. RUTH ELLEN HOLLO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD036812	DC

General Provider Information

NPI Number	:	1184604050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUTH ELLEN HOLLO MD

Provider Business Mailing Address
First Line	:	613 LEXINGTON PL NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-5219
Country	:	US
Telephone Number	:	202-544-6234
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 MICHIGAN AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20010-2978
Country	:	US
Telephone Number	:	202-476-6878
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	10/22/2007

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