Healthcare Provider Details

I. General information

NPI: 1477575322
Provider Name (Legal Business Name): RUTH WILF CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 02/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 SPRUCE ST STE 305
PHILADELPHIA PA
19106
US

IV. Provider business mailing address

3624 MARKET ST UPHS OFFICE OF MEDICAL AFFAIRS STE 560W
PHILADELPHIA PA
19104
US

V. Phone/Fax

Practice location:
  • Phone: 215-829-8000
  • Fax: 215-829-3701
Mailing address:
  • Phone: 215-662-2286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberMW008059L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: