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MARY RUDDY PA-C
NPI 1164541058
Physician Assistant - Surgical in Detroit, MI

Active since March 29, 2007
3990 JOHN R ST, DETROIT, MI 48201(313) 745-8040 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mary Ruddy Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY RUDDY PA-C (NPI 1164541058) is an individual surgical provider in Detroit, Michigan, licensed in Michigan (5601004329) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1164541058
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameMARY RUDDYCredential: PA-C
Location Address3990 JOHN R STDetroit, MI 48201-2018
Mailing Address3990 John R St Dept NeurosurgeDetroit, MI 48201-2018 · (313) 578-2245
Phone(313) 745-8040
Sole ProprietorNo
Enumeration DateMarch 29, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1164541058 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in MI · 5601004329
3990 JOHN R ST, Detroit, MI 48201
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIMBERLY DAWN HARRIS CRNA
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 745-8521
CAROLINE L TALBERT CRNA
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 745-7600
CHISAOKWU DURU
Anesthesiology
3990 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 745-7233
MR. MOHAMED IBRAHIM BAZZI
Occupational Therapist
3990 JOHN R ST
DETROIT, MI 48201
Wayne County (810) 333-1822
DR. SAMIR F FULEIHAN M.D.
Anesthesiology
3990 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 745-8521
DR. KAMAL K NANGIA
Emergency Medicine
3990 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 745-8040
TODD E HAMILTON CRNA
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 745-7600
MITCHELL R BRADLEY CRNA
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 745-7600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Ruddy's NPI number?

The NPI number for Mary Ruddy is 1164541058. It was assigned to this individual provider in the NPPES registry on March 29, 2007.

Where is Mary Ruddy located?

Mary Ruddy practices at 3990 John R St, Detroit, MI 48201. The listed phone number is (313) 745-8040.

What is Mary Ruddy's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Mary Ruddy was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.