Provider Demographics
NPI:1275587719
Name:FRETTS, RUTH C (MD)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:C
Last Name:FRETTS
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 1:230 WORCESTER ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-5420
Mailing Address - Country:US
Mailing Address - Phone:781-431-5429
Mailing Address - Fax:781-431-5548
Practice Address - Street 1:230 WORCESTER ST
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-5420
Practice Address - Country:US
Practice Address - Phone:781-431-5429
Practice Address - Fax:781-431-5548
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75519207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0000334OtherNEIGHBORHOOD HEALTH PLAN
MAG437OtherHARVARD PILGRIM
MA075519OtherTUFTS HEALTH PLAN
MAJ12938OtherBLUE CROSS
MA4830595-001OtherCIGNA
MA3097820Medicaid
MA075519OtherTUFTS HEALTH PLAN
MA3097820Medicaid