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Individual

JUAN P RUIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9000 W WISCONSIN AVE, PEDIATRIC PULMONARY MEDICINE, MILWAUKEE, WI 53226-4874
(414) 266-6730
(414) 266-6742
Mailing address
9000 W WISCONSIN AVE, PEDIATRIC PULMONARY MEDICINE, MILWAUKEE, WI 53226-4874
(414) 266-6730
(414) 266-6742

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
46902
WI
2080P0214X
Pediatric Pulmonology Physician
Primary
46902
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080416161
BCBS
MI
05
1053347989
WI
01
1598712390
GROUP NPI
MI
01
381360529
TAX ID#
MI
05
4876065
MI
05
4876074
MI
05
4876083
MI
05
4876092
MI
05
4876109
MI
Enumeration date
06/23/2006
Last updated
06/14/2023
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