Provider Demographics
NPI:1932184256
Name:RUFF, MICHAEL E (MD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:E
Last Name:RUFF
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 1:721 W 13TH ST
Mailing Address - Street 2:STE 321
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546
Mailing Address - Country:US
Mailing Address - Phone:812-482-7918
Mailing Address - Fax:812-634-1644
Practice Address - Street 1:721 W 13TH ST
Practice Address - Street 2:STE 321
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546
Practice Address - Country:US
Practice Address - Phone:812-482-7918
Practice Address - Fax:812-634-1644
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01041837208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN450494518102OtherCARE SOURCE
000000291250OtherBCBS
IN100111100AMedicaid