Provider Demographics
NPI:1336302041
Name:MAGERA, RUTH (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:
Last Name:MAGERA
Suffix:
Gender:F
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE MEDICAL CENTER DRIVE
Mailing Address - Street 2:RADIOLOGY
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-0001
Mailing Address - Country:US
Mailing Address - Phone:603-650-3792
Mailing Address - Fax:603-650-0787
Practice Address - Street 1:ONE MEDICAL CENTER DRIVE
Practice Address - Street 2:RADIOLOGY
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-0001
Practice Address - Country:US
Practice Address - Phone:603-650-3792
Practice Address - Fax:603-650-0787
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT1957362085R0202X
MA2543162085R0202X
MA236733390200000X
NH167222085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program