Provider Demographics
NPI:1619287570
Name:JU, RUJIN (MD)
Entity type:Individual
Prefix:
First Name:RUJIN
Middle Name:
Last Name:JU
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 1:7740 WASHINGTON VILLAGE DR STE 160
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4056
Mailing Address - Country:US
Mailing Address - Phone:937-436-9825
Mailing Address - Fax:937-433-6508
Practice Address - Street 1:7740 WASHINGTON VILLAGE DR STE 160
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4056
Practice Address - Country:US
Practice Address - Phone:937-436-9825
Practice Address - Fax:937-433-6508
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-13
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-00445207V00000X
OH35.136858207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0366043Medicaid