Provider Demographics
NPI:1750489241
Name:RUCH, STUART WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:WILLIAM
Last Name:RUCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:25 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3129
Mailing Address - Country:US
Mailing Address - Phone:508-778-1829
Mailing Address - Fax:508-778-0113
Practice Address - Street 1:25 MAIN ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3129
Practice Address - Country:US
Practice Address - Phone:508-778-1829
Practice Address - Fax:508-778-0113
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230297207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA043488655OtherUNITED HEALTHCARE
11631128OtherCAQH
MA1750489241OtherNETWORK HEALTH
MA1750489241OtherUNICARE
MA2128926Medicaid
MA495422OtherTUFTS
MAAA73844OtherHARVARD PILGRIM
MA043488655OtherTRICARE
MAP00375288OtherMEDICARE ID
MA000000036937OtherBOSTON MEDICAL CENTER
MA1359049OtherAETNA
MA1750489241OtherGREAT WEST HEALTHCARE
MA6570015OtherCIGNA
MAJ40904OtherBLUE CROSS BLUE SHIELD
MA2128926Medicaid
MA1750489241OtherGREAT WEST HEALTHCARE