1912906512 NPI number — DR. JAMES W RUPPEL MD

Table of content: DR. JAMES W RUPPEL MD (NPI 1912906512)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912906512 NPI number — DR. JAMES W RUPPEL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUPPEL
Provider First Name:
JAMES
Provider Middle Name:
W
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912906512
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 12622
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELFAST
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04915-4017
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-481-6460
Provider Business Mailing Address Fax Number:
443-481-6515

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1460 RITCHIE HWY
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
ARNOLD
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21012-2730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-757-6327
Provider Business Practice Location Address Fax Number:
410-757-8461
Provider Enumeration Date:
07/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  D0025499 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0001 . This is a "BCBS" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 5368055 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 249501500 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3644141 . This is a "AETNA HMO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 9960 . This is a "KAISER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 35200809 . This is a "BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 607156100 . This is a "FEDERAL WORKMAN'S COMP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 2133459 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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