Individual
DAVID E RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1107 MEMORIAL DR, SUITE 201, DALTON, GA 30720-8668
(706) 277-7311
(706) 529-4837
Mailing address
1107 MEMORIAL DR, SUITE 201, DALTON, GA 30720-8668
(706) 277-7311
(706) 529-4837
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
18419
TN
207P00000X
Emergency Medicine Physician
18419
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3801292
—
TN
05
—
3801293
—
TN
01
—
40218
TLC TENNCARE
TN
01
—
4031705
BLUE CROSS
TN
01
—
4152426
BLUE CROSS
TN
01
—
P00297047
MEDICARE RAILROAD
TN
Enumeration date
06/06/2006
Last updated
12/20/2021
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