Provider Demographics
NPI:1386714525
Name:HAN, RUJING (MD)
Entity type:Individual
Prefix:
First Name:RUJING
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CENTERVILLE RD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-0200
Mailing Address - Country:US
Mailing Address - Phone:401-921-0252
Mailing Address - Fax:
Practice Address - Street 1:300 CENTERVILLE RD
Practice Address - Street 2:SUITE 215
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-0200
Practice Address - Country:US
Practice Address - Phone:401-921-0252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233573207ZP0101X
RIMD13530207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2141744Medicaid
MA000231902Medicare PIN
MAI67923Medicare UPIN