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Individual

SHANE RUCKLE

Active
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Individual

SHANE RUCKLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
241661
NY
207P00000X
Emergency Medicine Physician
4490
WI
207P00000X
Emergency Medicine Physician
Primary
MD067927L
PA
207P00000X
Emergency Medicine Physician
V1699
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001769535
—
PA
Enumeration date
07/10/2006
Last updated
05/29/2026
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