Provider Demographics
NPI:1003817073
Name:RUISCH, ABBIE D (DO)
Entity Type:Individual
Prefix:DR
First Name:ABBIE
Middle Name:D
Last Name:RUISCH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50302-0424
Mailing Address - Country:US
Mailing Address - Phone:515-875-9255
Mailing Address - Fax:515-875-9223
Practice Address - Street 1:5501 NW 86TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131
Practice Address - Country:US
Practice Address - Phone:515-875-9035
Practice Address - Fax:515-875-9036
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADO-03458207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAH74844Medicare UPIN
IAI12353Medicare ID - Type Unspecified