Organization
MY MD HOUSECALLS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN R RUARK (MEMBER)
(734) 414-9990
Entity
Organization
Contact information
Practice address
9002 N MERIDIAN ST, SUITE 209, INDIANAPOLIS, IN 46260-5381
(317) 848-4460
(317) 848-4493
Mailing address
801 W ANN ARBOR TRL, SUITE 200, PLYMOUTH, MI 48170-1694
(734) 414-9990
(775) 258-1535
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
213E00000X
Podiatrist
—
IN
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
IN
363L00000X
Nurse Practitioner
—
IN
Other
Enumeration date
10/15/2010
Last updated
04/22/2011
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