Basic Information
| Provider Information | |||||||||
| NPI: | 1215344122 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUZIEH | ||||||||
| FirstName: | MOHAMMED | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3120 GLENDALE AVE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193833627 | ||||||||
| FaxNumber: | 4193833079 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | HERSHEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170332360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175310000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2014 | ||||||||
| LastUpdateDate: | 07/27/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME143783 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207U00000X | ME143783 | FL | N | Allopathic & Osteopathic Physicians | Nuclear Medicine | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RC0000X | ME143783 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 106394300 | 05 | FL | MEDICAID |