Provider Demographics
NPI:1689636060
Name:RUTMAN, DEANNA LOVE (MD)
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:LOVE
Last Name:RUTMAN
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 1:1910 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
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027133E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB33548Medicare UPIN
PA076523Medicare ID - Type Unspecified