Provider Demographics
NPI:1528053089
Name:MIGUEL, RUBEN A (MD)
Entity type:Individual
Prefix:
First Name:RUBEN
Middle Name:A
Last Name:MIGUEL
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 1:7575 NORTHCLIFF AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BROOKLYN
Mailing Address - State:OH
Mailing Address - Zip Code:44144-3267
Mailing Address - Country:US
Mailing Address - Phone:216-398-8196
Mailing Address - Fax:216-398-8192
Practice Address - Street 1:7575 NORTHCLIFF AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:BROOKLYN
Practice Address - State:OH
Practice Address - Zip Code:44144-3267
Practice Address - Country:US
Practice Address - Phone:216-398-8196
Practice Address - Fax:216-398-8192
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35035000207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000030862OtherUNICARE
P35000OtherSUMMACARE
OH341847368035OtherCARESOURCE
105350OtherKAISER
000000030862OtherANTHEM
OH393476OtherWELLCARE OF OHIO
OH0242759Medicaid
000000030862OtherANTHEM
OH0242759Medicaid
P35000OtherSUMMACARE