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Individual

KEVIN RUETER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1247 NE MEDICAL CENTER DR, SUITE 3, BEND, OR 97701-3786
(541) 318-4249
(541) 278-8377
Mailing address
1247 NE MEDICAL CENTER DR, SUITE 3, BEND, OR 97701-3786
(541) 318-4249
(541) 278-8377

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
125-049880
IL
207Q00000X
Family Medicine Physician
Primary
MD28648
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500605395
OR
Enumeration date
05/03/2007
Last updated
08/20/2012
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