Basic Information
| Provider Information | |||||||||
| NPI: | 1427079326 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUHSAM | ||||||||
| FirstName: | SHARON | ||||||||
| MiddleName: | JEANINE | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4225 GOLDEN VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | GOLDEN VALLEY | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554224215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7633024102 | ||||||||
| FaxNumber: | 7632872309 | ||||||||
| Practice Location | |||||||||
| Address1: | 4225 GOLDEN VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | GOLDEN VALLEY | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554224215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7633024102 | ||||||||
| FaxNumber: | 7632872309 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 225100000X | 970 | MN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | HP56054 | 01 | MN | HEALTHPARTNERS | OTHER | 962871010735 | 01 | MN | PREFERRED ONE | OTHER | 181H5RU | 01 | MN | BCBS OF MN | OTHER | 2387931 | 01 | MN | AMERICA'S PPO | OTHER | 6405857 | 01 | MN | MEDICA | OTHER |