Provider Demographics
NPI:1659339232
Name:RUTH, COREY KADES (MD)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:KADES
Last Name:RUTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:227 N BROAD ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1511
Mailing Address - Country:US
Mailing Address - Phone:215-988-0611
Mailing Address - Fax:215-988-0722
Practice Address - Street 1:1500 MARKET STREET
Practice Address - Street 2:24TH FLOOR-WEST TOWER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102
Practice Address - Country:US
Practice Address - Phone:215-255-3828
Practice Address - Fax:215-255-3577
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2015-11-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD027112E204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1045080Medicaid
PA1045080Medicaid
PA420144Medicare UPIN