Provider Demographics
NPI:1104858851
Name:GU, RUILI (MD)
Entity Type:Individual
Prefix:
First Name:RUILI
Middle Name:
Last Name:GU
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 1:1 HUTCHINSON DR
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3748
Mailing Address - Country:US
Mailing Address - Phone:978-739-6950
Mailing Address - Fax:978-777-9274
Practice Address - Street 1:1 HUTCHINSON DR
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3748
Practice Address - Country:US
Practice Address - Phone:978-739-6950
Practice Address - Fax:978-777-9274
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA150606207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0159662Medicaid
MAJ18040OtherBCBS OF MA
MA2654764OtherAETNA
MAJ18040OtherBCBS OF MA
MAA23081Medicare ID - Type UnspecifiedMEDICARE