Healthcare Provider Details

I. General information

NPI: 1205802956
Provider Name (Legal Business Name): RUTH SHERMAN BENNETT DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RUTH M. SHERMAN DO

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 10/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 E 32ND ST
SILVER CITY NM
88061-7251
US

IV. Provider business mailing address

71 KINGSTON MAIN ST
HILLSBORO NM
88042
US

V. Phone/Fax

Practice location:
  • Phone: 575-538-4000
  • Fax:
Mailing address:
  • Phone: 575-740-8169
  • Fax: 405-553-5633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA-1446-08
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA-1446-08
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: