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Individual

DR. PAUL ANDY RUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5109 36TH AVE N, CRYSTAL, MN 55422-2007
(763) 587-7900
(763) 587-7989
Mailing address
5109 36TH AVE N, CRYSTAL, MN 55422-2007
(763) 587-7900
(763) 587-7989

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24848
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01-13065
MEDICA
MN
05
116213
MN
01
20177
SIOUX VALLEY
MN
01
555707
ARAZ
MN
01
5T429RU
BLUE CROSS
MN
05
5T429RU
MN
05
844563000
MN
05
959544
IA
01
A009
CHAMPUS
MN
01
HP29844
HEALTH PARTNERS
MN
01
MH9041000380
PREFERRED ONE
MN
Enumeration date
12/01/2005
Last updated
10/20/2020
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