Provider Demographics
NPI:1851395818
Name:RUTH, THOMAS K (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:K
Last Name:RUTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 829641
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0001
Mailing Address - Country:US
Mailing Address - Phone:267-370-5296
Mailing Address - Fax:215-230-3725
Practice Address - Street 1:1456 FERRY RD UNIT 600
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2395
Practice Address - Country:US
Practice Address - Phone:215-230-8390
Practice Address - Fax:215-230-8392
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA032497E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA9120903001OtherCIGNA PROVIDER NUMBER
PA0010546140001Medicaid
PA695281OtherAETNA US HEALTHCARE PROVI
PA695281OtherAETNA US HEALTHCARE PROVI
PA0010546140001Medicaid