Provider Demographics
NPI:1831144179
Name:RUTHRUFF, CHRISTOPHER M (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:M
Last Name:RUTHRUFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:550 E WASHINGTON ST
Mailing Address - Street 2:STE 205
Mailing Address - City:IONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48846-2202
Mailing Address - Country:US
Mailing Address - Phone:616-527-8293
Mailing Address - Fax:616-527-5718
Practice Address - Street 1:550 E WASHINGTON ST
Practice Address - Street 2:STE 205
Practice Address - City:IONIA
Practice Address - State:MI
Practice Address - Zip Code:48846-2202
Practice Address - Country:US
Practice Address - Phone:616-527-8293
Practice Address - Fax:616-527-5718
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MICR070864207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1016882OtherMCLAREN
700C460070OtherBCBS GROUP NUMBER
MI104425019Medicaid
MI383218134OtherTRICARE
MI4425019OtherMOLINA
MI01349OtherPRIORITY HEALTH PAY TO #
MI200000002259OtherPHPMM
MI135697200OtherUS DEPARTMENT OF LABOR
MI01349OtherPRIORITY HEALTH PAY TO #
MI104425019Medicaid