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General NPI Number Information
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NPI Number | 1053930057
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Entity Type | Individual
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Provider Name | RUTH WOLDEMICHAEL MD
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Gender | Female
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Dates
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Enumeration Date | 04/10/2020
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Last Update Date | 06/27/2024
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Provider Practice Location Address
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Address Line | 3701 MARKET ST FL 3
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City | PHILADELPHIA
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State | PA
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Zip | 19104-5505
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Country | US
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Telephone | 215-316-5151
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Fax |
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Provider Business Mailing Address
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Address Line | 201 S 25TH ST APT 223
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City | PHILADELPHIA
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State | PA
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Zip | 19103-6010
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Country | US
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Telephone | 806-677-9105
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | MD485863
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License Number State | PA
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