Provider Demographics
NPI:1700827151
Name:STEMP, RUTH G (MD)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:G
Last Name:STEMP
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 1:528 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-5757
Mailing Address - Country:US
Mailing Address - Phone:401-276-6151
Mailing Address - Fax:401-276-4124
Practice Address - Street 1:530 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-5762
Practice Address - Country:US
Practice Address - Phone:401-276-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD075022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI005327OtherBLUE CHIP
RI007059466OtherMEDICARE ID-TYPE UNSPECIFIED
RI30884-5OtherBLUE CROSS
RI7000730Medicaid
RI1104801349OtherBUTLER HOSPITAL NPI
RI1104847946OtherTHE PROVIDENCE CENTER NPI
RI15-18943OtherUNITED BEHAVIORAL HEALTH
1093831646OtherBUTLER HOSPITAL PROFESSIONAL BILLING OFFICE
RI15-18943OtherUNITED BEHAVIORAL HEALTH