Provider Demographics
NPI:1124013180
Name:RUZICH, ANDREW HINKLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:HINKLEY
Last Name:RUZICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 W ALLEGHENY RD
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:PA
Mailing Address - Zip Code:15126-9775
Mailing Address - Country:US
Mailing Address - Phone:724-695-3371
Mailing Address - Fax:724-695-3372
Practice Address - Street 1:236 W ALLEGHENY RD
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:PA
Practice Address - Zip Code:15126-9775
Practice Address - Country:US
Practice Address - Phone:724-695-3371
Practice Address - Fax:724-695-3372
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-15
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058699L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001695766OtherHIGHMARK
PA206789OtherUPMC
PA10935378OtherCAQH
PA3815115OtherAETNA
PA1500039OtherGATEWAY
PA258371OtherHEALTH ASSUR/ADVANTRA
PA001695766OtherHIGHMARK