MEDICARE: BRIAN C RULEY 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	207Q00000X	Family Medicine Physician	01060955A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346518958
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIAN C RULEY MD

Provider Business Mailing Address
First Line	:	3440 S POST RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46239-8301
Country	:	US
Telephone Number	:	317-862-0858
Fax Number	:	317-862-5102

Provider Business Practice Location Address
First Line	:	3440 S POST RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46239-8301
Country	:	US
Telephone Number	:	317-862-0858
Fax Number	:	317-862-5102

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BRIAN CHRISTOPHER RULEY
Credential	:	MD
Telephone Number	:	317-862-0858

Provider Enumeration Date	:	12/09/2011
Last Update Date	:	12/09/2011

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