Provider Demographics
NPI:1609880269
Name:RUANE, EDWARD WILLIAM (DPM)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:WILLIAM
Last Name:RUANE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 W GERMANTOWN PIKE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19401-1385
Mailing Address - Country:US
Mailing Address - Phone:610-279-3080
Mailing Address - Fax:610-292-8384
Practice Address - Street 1:190 W GERMANTOWN PIKE
Practice Address - Street 2:SUITE 120
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19401-1385
Practice Address - Country:US
Practice Address - Phone:610-279-3080
Practice Address - Fax:610-292-8384
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003413L213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA23-2705629OtherTAX IDENTIFICATION NUMBER
PA232969552OtherTAX ID NUMBER
PA23-2705629OtherTAX IDENTIFICATION NUMBER
U13992Medicare UPIN
PA021782Medicare ID - Type UnspecifiedGROUP MEDICARE #