Provider Demographics
NPI:1134261894
Name:RUFO, ROGELIO BULATAO (MD)
Entity type:Individual
Prefix:DR
First Name:ROGELIO
Middle Name:BULATAO
Last Name:RUFO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7384 WOODCROFT DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-1294
Mailing Address - Country:US
Mailing Address - Phone:513-755-8587
Mailing Address - Fax:
Practice Address - Street 1:3801 HAUCK RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-4607
Practice Address - Country:US
Practice Address - Phone:513-563-1505
Practice Address - Fax:513-769-4776
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH036350207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0241429Medicaid
OH0241429Medicaid
OHRUO398401Medicare UPIN