Provider Demographics
NPI:1578622098
Name:RUATTO, MICHELE LYNN (AUD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:LYNN
Last Name:RUATTO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30055 NORTHWESTERN HWY
Mailing Address - Street 2:STE 101
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3260
Mailing Address - Country:US
Mailing Address - Phone:586-226-3800
Mailing Address - Fax:
Practice Address - Street 1:30055 NORTHWESTERN HWY
Practice Address - Street 2:SUITE #101
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3230
Practice Address - Country:US
Practice Address - Phone:248-865-4166
Practice Address - Fax:248-865-4198
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501002934237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI640F329790OtherBCBS-MI AUDIOLOGY SERVICE
MI90-4845372Medicaid
MI540F329780OtherBCBS-MI HEARING AID NUMBE