Ku-Ruth, Phyllidia M.

Ku-Ruth, Phyllidia M. is an individual health care provider with primary practice located at 84 Marginal Way Suite 800, Portland ME 04101-2443. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Ku-Ruth, Phyllidia M. can be contacted via phone (207) 774-5816.

Contact Information

Primary practice address
84 Marginal Way Suite 800 Portland ME 04101-2443
Phone: (207) 774-5816
Fax: (207) 774-7831
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 015348 Maine

Profile Details

NPI number 1497724108
LBN Legal business name Ku-Ruth, Phyllidia M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2006
Last updated Mar 6th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497724108 NPPES
Other 2456790 AETNA
MEDICAID 309140099 AETNA
Other 061137 AETNA

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