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NPI Code Detail

MEDICARE: DARYLE A RUARK MD ORTHOPEDIC SURGEON PC

MEDICARE: DARYLE A RUARK MD ORTHOPEDIC SURGEON PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1487130530
Entity Type Code : Organization
Provider Name (Legal Business Name) : DARYLE A RUARK MD ORTHOPEDIC SURGEON PC
Provider Business Mailing Address
First Line : 299 CAREW ST STE 409
Second Line :
City : SPRINGFIELD
State : MA
Zip : 01104-2361
Country : US
Telephone Number : 413-788-7321
Fax Number : 413-733-6369
Provider Business Practice Location Address
First Line : 299 CAREW ST STE 409
Second Line :
City : SPRINGFIELD
State : MA
Zip : 01104-2361
Country : US
Telephone Number : 413-788-7321
Fax Number : 413-733-6369
Authorized Official
Title or Position : OWNER
Name : DARYLE A RUARK
Credential :
Telephone Number : 413-509-1000
Provider Enumeration Date : 07/12/2018
Last Update Date : 09/21/2018

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