MEDICARE: DR. PAULA LYNN RUFFIN DC

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	111N00000X	Chiropractor	PR007680	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	950F328890	OTHER	MI	BCBS OF MI
2	NE008753	OTHER	MI	M-CARE

General Provider Information

NPI Number	:	1578596367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAULA LYNN RUFFIN DC

Provider Business Mailing Address
First Line	:	30033 SHEFPO
Second Line	:	PO BOX 315
City	:	NEW HUDSON
State	:	MI
Zip	:	48165
Country	:	US
Telephone Number	:	248-486-5684
Fax Number	:	248-486-5686

Provider Business Practice Location Address
First Line	:	30033 SHEFPO
Second Line	:
City	:	NEW HUDSON
State	:	MI
Zip	:	48165
Country	:	US
Telephone Number	:	248-486-5684
Fax Number	:	248-486-5686

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

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	08/24/2010

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