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General NPI Number Information
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NPI Number | 1508870882
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Entity Type | Individual
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Provider Name | MAIA RUTMAN MD
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Gender | Female
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | ONE MEDICAL CENTER DR DARTMOUTH HITCHCOCK MED CTR EMERGENCY DPTMT
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City | LEBNON
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State | NH
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Zip | 03756-0001
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Country | US
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Telephone | 603-650-7254
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Fax | 603-650-0473
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Provider Business Mailing Address
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Address Line | ONE MEDICAL CENTER DRIVE DARTMOUTH HITCHCOCK MED CTR DEPARTMENT OF PEDIATRICS
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City | LEBANON
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State | NH
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Zip | 03756-0001
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Country | US
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Telephone | 603-650-7254
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Fax | 603-650-0473
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD11521
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 13562
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License Number State | NH
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