Provider Demographics
NPI:1326044231
Name:GONZALEZ-RUIZ, ANTONIO R (MD)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:R
Last Name:GONZALEZ-RUIZ
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 1:2006 BROOKWOOD MEDICAL CTR DR
Mailing Address - Street 2:WOMEN'S MEDICAL PLAZA, SUITE 604
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6899
Mailing Address - Country:US
Mailing Address - Phone:205-877-5113
Mailing Address - Fax:205-877-5130
Practice Address - Street 1:2006 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:WOMEN'S MEDICAL PLAZA, SUITE 604
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-6899
Practice Address - Country:US
Practice Address - Phone:205-877-5113
Practice Address - Fax:205-877-5130
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL28887207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000064957OtherANTHEM MEDICAID
OH344428256OtherEMERALD
CA344428256OtherBEECH STREET
OHOC02562OtherNATIONWIDE
OH124629OtherCARE CHOICES
OH344428256099OtherCARESOURCES
MI3489970Medicaid
MI9180OtherHEALTH PLAN MI
OH01616OtherPARAMOUNT
OH4326824OtherAETNA
MI124629OtherPRIORITY HEALTH
MI19687OtherGREAT LAKES HEALTH CARE
OH0929802Medicaid
OH344428256OtherFRONTPATH
MIC36324OtherHEALTH ALLICANCE PLAN
OH000000064957OtherANTHEM COMMERICAL
OH344428256OtherEMERALD
MIC36324OtherHEALTH ALLICANCE PLAN
OH344428256099OtherCARESOURCES