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Individual

RAINIER RUIZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8608 DAVID AVE, PARKVILLE, MD 21234-4221
(410) 882-9229
Mailing address
8608 DAVID AVE., PARKVILLE, MD 21234-4221

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R167428
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R200730297047
DRIVERS LICENSE
MD
Enumeration date
06/11/2010
Last updated
06/11/2010
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