Provider Demographics
NPI:1376668335
Name:DEANNA LOVE RUTMAN, M.D., P.C.
Entity Type:Organization
Organization Name:DEANNA LOVE RUTMAN, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:LOVE
Authorized Official - Last Name:RUTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-561-6191
Mailing Address - Street 1:1910 COCHRAN RD
Mailing Address - Street 2:MANOR OAK VILLAGE
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-1102
Mailing Address - Country:US
Mailing Address - Phone:412-561-6191
Mailing Address - Fax:412-561-5736
Practice Address - Street 1:1910 COCHRAN RD
Practice Address - Street 2:MANOR OAK VILLAGE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-1102
Practice Address - Country:US
Practice Address - Phone:412-561-6191
Practice Address - Fax:412-561-5736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027133E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA076523Medicare ID - Type UnspecifiedMEDICARE
PAB33548Medicare UPIN