Provider Demographics
NPI:1417930488
Name:RULLAN, RAMON (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:
Last Name:RULLAN
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:#68 CALLE SANTA CRUZ- TORRE SAN PABLO
Mailing Address - Street 2:SUITE 704
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-288-6998
Mailing Address - Fax:
Practice Address - Street 1:#68 CALLE SANTA CRUZ- TORRE SAN PABLO
Practice Address - Street 2:SUITE 703
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-288-6998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16422207RG0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0186279Medicaid
MARU A34040Medicare ID - Type Unspecified
MA0186279Medicaid
MAH62293Medicare UPIN