Basic Information
Provider Information | |||||||||
NPI: | 1881814846 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | RUFF | ||||||||
FirstName: | SARAH | ||||||||
MiddleName: | CHRISTINE | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2000 PERIMETER PARK DR STE 200 | ||||||||
Address2: |   | ||||||||
City: | MORRISVILLE | ||||||||
State: | NC | ||||||||
PostalCode: | 275608442 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: |   | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 6013 FARRINGTON RD STE 101 | ||||||||
Address2: |   | ||||||||
City: | CHAPEL HILL | ||||||||
State: | NC | ||||||||
PostalCode: | 275178173 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9849747010 | ||||||||
FaxNumber: | 9849747020 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/01/2007 | ||||||||
LastUpdateDate: | 08/10/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 08/10/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 4301092072 | MI | N |   | Allopathic & Osteopathic Physicians | Family Medicine |   | 207Q00000X | 2012-01634 | NC | Y |   | Allopathic & Osteopathic Physicians | Family Medicine |   |
ID Information
ID | Type | State | Issuer | Description | 01014684 | 01 | MI | HEALTHPLUS OF MICHIGAN | OTHER | 1881814846 | 01 | MI | MOLINA HEALTH PLAN OF MI | OTHER | 50892 | 01 | MI | HEALTH PLAN OF MICHIGAN | OTHER | 080G310660 | 01 | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN | OTHER | 381908328 | 01 | MI | PRIORITY HEALTH | OTHER | 1036889 | 01 | MI | MCLAREN HEALTH PLAN | OTHER | 1881814846 | 05 | MI |   | MEDICAID | 381908328 | 01 | MI | HCAP | OTHER | 172153 | 01 | MI | GREAT LAKES HEALTH PLAN OF MI | OTHER | 421 | 01 | MI | CARE SOURCE OF MICHIGAN JANES ST | OTHER |