Individual provider · Type 1 NPI

Mary Ruddy, PA-C

Surgical Physician Assistant · Detroit, MI

NPI number 1164541058 Active

Practice location

3990 John R St
Detroit, MI 48201-2018

Call (313) 745-8040 Map

Mailing address

3990 John R St Dept Neurosurge
Detroit, MI 48201-2018

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X5601004329 (MI)

Surgical Physician Assistant: Definition to come...

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About NPI 1164541058

Mary Ruddy, PA-C's National Provider Identifier is 1164541058, issued on Mar 29, 2007. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Detroit, MI. The record was last updated on Jul 8, 2007.