Provider Demographics
NPI:1629037387
Name:RUFTY, ALFRED J JR (MD)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:J
Last Name:RUFTY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:150 CHARLOIS BLVD
Mailing Address - Street 2:SUITE 223
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1549
Mailing Address - Country:US
Mailing Address - Phone:336-765-2500
Mailing Address - Fax:336-765-2555
Practice Address - Street 1:150 CHARLOIS BLVD
Practice Address - Street 2:SUITE 223
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1549
Practice Address - Country:US
Practice Address - Phone:336-765-2500
Practice Address - Fax:336-765-2555
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC16546207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8973970OtherMEDICAID
VA1629037387OtherMEDICAID
NC73970OtherBCBS
NC73970OtherBCBS
NC8973970OtherMEDICAID
NC2100788DMedicare PIN