Basic Information
| Provider Information | |||||||||
| NPI: | 1891084224 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUAN | ||||||||
| FirstName: | SHUOLUN | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 E UNIVERSITY PKWY | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105542107 | ||||||||
| FaxNumber: | 4105542110 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 E UNIVERSITY PKWY | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105542107 | ||||||||
| FaxNumber: | 4105542110 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2011 | ||||||||
| LastUpdateDate: | 07/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD-22642 | HI | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | D0077589 | MD | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.