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Individual

DR. JUAN CARLOS RUBEN RUIZ DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3098 OAK GROVE RD, POPLAR BLUFF, MO 63901-8938
(573) 778-2600
Mailing address
1067 RHINELANDER AVE FL 1, BRONX, NY 10461-1339
(718) 502-1894

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
290770
NY
207RC0000X
Cardiovascular Disease Physician
Primary
2021036284
MO

Other

Enumeration date
07/12/2014
Last updated
11/09/2021
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