Provider Demographics
NPI:1295235372
Name:MAZZUCCHELLI, RUBEN ANGIOLO (MD)
Entity type:Individual
Prefix:MR
First Name:RUBEN
Middle Name:ANGIOLO
Last Name:MAZZUCCHELLI
Suffix:
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 1:901 FOT; 510 20TH STREET SOUTH
Mailing Address - Street 2:UAB DEPARTMENT OF ORTHOPAEDIC SURGERY
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:901 FOT; 510 20TH STREET SOUTH
Practice Address - Street 2:UAB DEPARTMENT OF ORTHOPAEDIC SURGERY
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294
Practice Address - Country:US
Practice Address - Phone:205-934-6413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program