Provider Demographics
NPI:1588618714
Name:RUFF, MELINDA LEE (MD)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:LEE
Last Name:RUFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:
Other - Last Name:RIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2350 MIAMI VALLEY DR
Mailing Address - Street 2:SUITE 530
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4778
Mailing Address - Country:US
Mailing Address - Phone:937-435-3546
Mailing Address - Fax:937-435-3568
Practice Address - Street 1:2350 MIAMI VALLEY DR
Practice Address - Street 2:SUITE 530
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4778
Practice Address - Country:US
Practice Address - Phone:937-435-3546
Practice Address - Fax:937-435-3568
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH81078207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2840448Medicaid
OH2840448Medicaid
OH4247351Medicare PIN