Ruffin, Shomari Andre

Ruffin, Shomari Andre is an sole proprietor health care provider with primary practice located at 150 Clinic Ave Suite 101, Carrollton GA 30117-4401. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Ruffin, Shomari Andre can be contacted via phone (770) 834-0873.

Contact Information

Primary practice address
150 Clinic Ave Suite 101 Carrollton GA 30117-4401
Phone: (770) 834-0873
Fax: (770) 834-6118
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 72107 Georgia

Profile Details

NPI number 1114185840
LBN Legal business name Ruffin, Shomari Andre
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 29th, 2008
Last updated Oct 30th, 2014 - about 11 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 1114185840 NPPES
Georgia MEDICAID REF000630555

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