Provider Demographics
NPI:1730321779
Name:RUIZ-GUTIERREZ, MELISA (MD, PHD)
Entity Type:Individual
Prefix:MRS
First Name:MELISA
Middle Name:
Last Name:RUIZ-GUTIERREZ
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 LONGWOOD AVE
Mailing Address - Street 2:KARP 08215
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:617-919-2009
Mailing Address - Fax:617-730-0934
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:KARP 08215
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-919-2009
Practice Address - Fax:617-730-0934
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2655082080P0207X, 2080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology