Provider Demographics
NPI:1497048235
Name:RUIZ, EMILIA (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILIA
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:EMILIA
Other - Middle Name:
Other - Last Name:RUIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2628 ARBOR DR
Mailing Address - Street 2:#300
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-1972
Mailing Address - Country:US
Mailing Address - Phone:805-705-9533
Mailing Address - Fax:
Practice Address - Street 1:1 SCIENCE CT
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-1055
Practice Address - Country:US
Practice Address - Phone:608-280-7059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036136068207R00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine