Individual
DR. RANDALL RUVALCABA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19333 W NORTH AVE, BROOKFIELD, WI 53045-4132
(414) 258-3939
Mailing address
19333 W NORTH AVE, BROOKFIELD, WI 53045-4132
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34562
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32119800
—
WI
Enumeration date
06/18/2006
Last updated
07/09/2007
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