Organization
STEPHEN RALPH RIBAUDO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN RALPH RIBAUDO M.D. (PRESIDENT)
(574) 252-5852
Entity
Organization
Contact information
Practice address
229 RED COACH DR, SUITE 102, MISHAWAKA, IN 46545-3195
(574) 525-5852
(574) 252-5862
Mailing address
229 RED COACH DR, SUITE 102, MISHAWAKA, IN 46545-3195
(574) 525-5852
(574) 252-5862
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
01034333
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200886440A
—
IN
01
—
DG1929
MEDICARE RAILROAD
IN
Enumeration date
06/06/2007
Last updated
12/21/2020
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