Basic Information
| Provider Information | |||||||||
| NPI: | 1437106325 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUHLMAN | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | DONALD | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 611 MOCKSVILLE AVE | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281442705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7046337220 | ||||||||
| FaxNumber: | 7046470515 | ||||||||
| Practice Location | |||||||||
| Address1: | 611 MOCKSVILLE AVE | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281442705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7046337220 | ||||||||
| FaxNumber: | 7046470515 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2006 | ||||||||
| LastUpdateDate: | 01/10/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 100449 | NC | N | Allopathic & Osteopathic Physicians | Family Medicine | 363A00000X | 100449 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 8101556 | 05 | NC | MEDICAID |