MEDICARE: GEORGE M RUTAN D.P.M., F.A.C.F.A.S.

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	213E00000X	Podiatrist	36001740	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00252830	OTHER	OH	RAILROAD MEDICARE

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	:	1538162326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE M RUTAN D.P.M., F.A.C.F.A.S.

Provider Business Mailing Address
First Line	:	3663 RIDGE MILL DR
Second Line	:	SUITE 104
City	:	HILLIARD
State	:	OH
Zip	:	43026-7799
Country	:	US
Telephone Number	:	614-529-7800
Fax Number	:	614-529-7802

Provider Business Practice Location Address
First Line	:	3663 RIDGE MILL DR
Second Line	:	SUITE 104
City	:	HILLIARD
State	:	OH
Zip	:	43026-7799
Country	:	US
Telephone Number	:	614-529-7800
Fax Number	:	614-529-7802

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	03/12/2013

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