Provider Demographics
NPI:1487681532
Name:RUELAN, MIGUEL M JR (DC)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:M
Last Name:RUELAN
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 WOODLAND PONDS DR
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-3612
Mailing Address - Country:US
Mailing Address - Phone:810-701-1876
Mailing Address - Fax:
Practice Address - Street 1:3280 N ELMS RD
Practice Address - Street 2:STE E
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-1871
Practice Address - Country:US
Practice Address - Phone:810-659-9700
Practice Address - Fax:810-659-9740
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMR008160111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2377319340OtherAETNA
MI95-OB51319OtherBCBS
MI95-OB51319OtherBCBS
MI2377319340OtherAETNA