Individual
GARY STEPHEN RUOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
201 SOUTH GARFIELD AVE, TRAVERSE CITY, MI 49686
(231) 935-0580
(231) 935-0584
Mailing address
201 SOUTH GARFIELD AVE, TRAVERSE CITY, MI 49686
(231) 935-0580
(231) 935-0584
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101013402
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27136
PRIORITY HEALTH PAYER COD
MI
01
—
383559647
TAX ID
MI
05
—
4321711
—
MI
01
—
5280086
BLUE CROSS BLUE SHIELD
MI
Enumeration date
10/03/2006
Last updated
03/11/2021
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