# MY MD HOUSECALLS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942510623
- **Authorized official:** KEVIN R RUARK (MEMBER)
- **Authorized official phone:** (734) 414-9990

## Contact information

- **Practice address:** 9002 N MERIDIAN ST, SUITE 209, INDIANAPOLIS, IN 46260-5381
- **Practice address phone:** (317) 848-4460
- **Practice address fax:** (317) 848-4493
- **Mailing address:** 801 W ANN ARBOR TRL, SUITE 200, PLYMOUTH, MI 48170-1694
- **Mailing address phone:** (734) 414-9990
- **Mailing address fax:** (775) 258-1535

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 213E00000X | Podiatrist | — | IN | — |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | IN | — |
| 363L00000X | Nurse Practitioner | — | IN | — |

## Other

- **Enumeration date:** 10/15/2010
- **Last updated:** 04/22/2011