Provider Demographics
NPI:1700937810
Name:HOLZHAUSER, RUTHANN (MD)
Entity Type:Individual
Prefix:DR
First Name:RUTHANN
Middle Name:
Last Name:HOLZHAUSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7599 GROTTO CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-1463
Mailing Address - Country:US
Mailing Address - Phone:614-431-1134
Mailing Address - Fax:614-431-1624
Practice Address - Street 1:7599 GROTTO CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-1463
Practice Address - Country:US
Practice Address - Phone:614-431-1134
Practice Address - Fax:614-431-1624
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35045292208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHE58140Medicare UPIN