Provider Demographics
NPI:1851321574
Name:RUA, MICHAEL DAVID (PA-C)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DAVID
Last Name:RUA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 RIDGEVIEW DR UNIT 3
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:15478-1650
Mailing Address - Country:US
Mailing Address - Phone:724-569-8100
Mailing Address - Fax:724-569-8368
Practice Address - Street 1:100 RIDGEVIEW DR UNIT 3
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:PA
Practice Address - Zip Code:15478
Practice Address - Country:US
Practice Address - Phone:724-569-8100
Practice Address - Fax:724-569-8368
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA003565L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1033293980001Medicaid
PAP33573Medicare UPIN