Most Relevant Information
Provider Data
| NPI Number: | 1003596016 |
| Provider Name: | RUVIM LEONTYEV CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 29045 |
Most Important Dates
| Enumeration Date: | 07/24/2023 |
| Last Updated: | 09/05/2024 |
Provider Practice Location
606 BLACK RIVER RD
GEORGETOWN
SC
294403304
Practice Location Phone/Fax
| Phone: | 8435277000 |
| Fax: |
Provider Mailing Location
14 LOCKWOOD DR APT 6A
CHARLESTON
SC
294011132
Provider Mailing Phone/Fax
| Phone: | 8643815477 |
| Fax: |