Provider Demographics
NPI:1043213564
Name:RUEHLE, STEPHEN SAMUEL (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:SAMUEL
Last Name:RUEHLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 QUAKER LN
Mailing Address - Street 2:STE 201C
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-3800
Mailing Address - Country:US
Mailing Address - Phone:336-841-7888
Mailing Address - Fax:336-841-6945
Practice Address - Street 1:624 QUAKER LN
Practice Address - Street 2:STE 201C
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3800
Practice Address - Country:US
Practice Address - Phone:336-841-7888
Practice Address - Fax:336-841-6945
Is Sole Proprietor?:No
Enumeration Date:2005-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23755207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8973860Medicaid
NC73860OtherBLUE CROSS BLUE SHIELD
NC4284079OtherAETNA
NC202219Medicare ID - Type Unspecified
NC8973860Medicaid