Provider Demographics
NPI:1083789424
Name:RUETSCHI, MAYA S (MD)
Entity Type:Individual
Prefix:
First Name:MAYA
Middle Name:S
Last Name:RUETSCHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HOSPITAL DRIVE
Mailing Address - Street 2:SUITE 122
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837
Mailing Address - Country:US
Mailing Address - Phone:570-524-1199
Mailing Address - Fax:570-522-6556
Practice Address - Street 1:3 HOSPITAL DRIVE
Practice Address - Street 2:SUITE 122
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837
Practice Address - Country:US
Practice Address - Phone:570-524-1199
Practice Address - Fax:570-522-6556
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038689L2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
B40361Medicare UPIN