Ruffalo, Phillip J

Ruffalo, Phillip J is an individual health care provider with primary practice located at 1213 15Th Ave W Suite 250, Williston ND 58801-3800. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Ruffalo, Phillip J can be contacted via phone (701) 577-0319.

Contact Information

Primary practice address
1213 15Th Ave W Suite 250 Williston ND 58801-3800
Phone: (701) 577-0319
Fax: (701) 572-7438
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X M5897 Idaho
Allopathic & Osteopathic Physicians / Surgery 208600000X 3813 Montana
Allopathic & Osteopathic Physicians / Surgery 208600000X ND3055 North Dakota

Profile Details

NPI number 1649252651
LBN Legal business name Ruffalo, Phillip J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649252651 NPPES
Montana Other 0031720 MT MEDICAID
Montana Other M5897 MT MEDICAID
Montana MEDICAID 013760 MT MEDICAID
Montana Other 594 MT MEDICAID
Montana Other 3813 MT MEDICAID

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