Basic Information
Provider Information
NPI: 1659380186
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STAMPS
FirstName: RUANNE
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 7687
Address2:  
City: COLUMBIA
State: MO
PostalCode: 652057687
CountryCode: US
TelephoneNumber: 5738822259
FaxNumber: 5738848526
Practice Location
Address1: 404 KEENE ST
Address2:  
City: COLUMBIA
State: MO
PostalCode: 652016626
CountryCode: US
TelephoneNumber: 5738759400
FaxNumber: 5738845410
Other Information
ProviderEnumerationDate: 08/05/2006
LastUpdateDate: 10/30/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X101363MON Allopathic & Osteopathic PhysiciansFamily Medicine 
207P00000X101363MOY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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