Provider Demographics
NPI:1376617449
Name:MYERS, RUTH MIZE (MD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:MIZE
Last Name:MYERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:14300 NICOLLET COURT
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306
Mailing Address - Country:US
Mailing Address - Phone:952-898-7578
Mailing Address - Fax:952-898-7592
Practice Address - Street 1:14300 NICOLLET COURT
Practice Address - Street 2:SUITE 207
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306
Practice Address - Country:US
Practice Address - Phone:952-898-7578
Practice Address - Fax:952-898-7592
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN495762084N0400X
MN495782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology