Basic Information
| Provider Information | |||||||||
| NPI: | 1356440481 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUHLAND | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2679 | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288022679 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282130594 | ||||||||
| FaxNumber: | 8282130590 | ||||||||
| Practice Location | |||||||||
| Address1: | 534 BILTMORE AVE | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2821305948 | ||||||||
| FaxNumber: | 8282130590 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2006 | ||||||||
| LastUpdateDate: | 06/13/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 2018-00614 | NC | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 49027 | MN | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 43205 | AZ | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 524517 | 05 | AZ | MEDICAID | 34777400 | 05 | WI | MEDICAID | 090438000 | 05 | MN | MEDICAID | P00888868 | 01 | AZ | RAILROAD MEDICARE | OTHER |