Provider Demographics
NPI:1972795516
Name:RIMKIENE, RUTA (MD)
Entity type:Individual
Prefix:DR
First Name:RUTA
Middle Name:
Last Name:RIMKIENE
Suffix:
Gender:F
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:PO BOX 530062
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-0062
Mailing Address - Country:US
Mailing Address - Phone:843-235-0760
Mailing Address - Fax:843-492-0177
Practice Address - Street 1:14866 OCEAN HWY
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-4801
Practice Address - Country:US
Practice Address - Phone:843-235-4111
Practice Address - Fax:843-492-4666
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC31287207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC312879Medicaid
NC5910853Medicaid
NC5910853Medicaid