MEDICARE: RUTH PROPHETE MD

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
1	208000000X	Pediatrics Physician	206719	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841274081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH PROPHETE MD

Provider Business Mailing Address
First Line	:	81 HAWTHORN ST # R
Second Line	:
City	:	NEW BEDFORD
State	:	MA
Zip	:	02740-3429
Country	:	US
Telephone Number	:	508-961-2403
Fax Number	:	508-961-2406

Provider Business Practice Location Address
First Line	:	81 HAWTHORN ST # R
Second Line	:
City	:	NEW BEDFORD
State	:	MA
Zip	:	02740-3429
Country	:	US
Telephone Number	:	508-961-2403
Fax Number	:	508-961-2406

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	01/06/2012

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Directions to “ RUTH PROPHETE MD” Practice Location

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