Provider Demographics
NPI:1164617148
Name:HEIM, RUTH A (PHD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:A
Last Name:HEIM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 COMPUTER DR
Mailing Address - Street 2:MOLECULAR GENETICS DIAGNOSTIC LABORATORY
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1771
Mailing Address - Country:US
Mailing Address - Phone:508-389-6656
Mailing Address - Fax:
Practice Address - Street 1:3400 COMPUTER DR
Practice Address - Street 2:MOLECULAR GENETICS DIAGNOSTIC LABORATORY
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1771
Practice Address - Country:US
Practice Address - Phone:508-389-6656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA96075207SG0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics