Provider Demographics
NPI:1316194541
Name:N.T. RUELOS, M.D., P.C.
Entity Type:Organization
Organization Name:N.T. RUELOS, M.D., P.C.
Other - Org Name:CARROLL MENTAL HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NELLIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:RUELOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-552-9004
Mailing Address - Street 1:1421 WOODRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-8338
Mailing Address - Country:US
Mailing Address - Phone:410-552-9983
Mailing Address - Fax:410-552-9984
Practice Address - Street 1:1643 LIBERTY RD
Practice Address - Street 2:STE. 204
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6544
Practice Address - Country:US
Practice Address - Phone:410-552-9004
Practice Address - Fax:410-552-9003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-19
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD303812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD590MMedicare UPIN