Organization
DARYLE A RUARK MD ORTHOPEDIC SURGEON PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARYLE RUARK MD (OWNER)
(413) 788-7321
Entity
Organization
Contact information
Practice address
299 CAREW ST STE 409, SPRINGFIELD, MA 01104
(413) 788-7321
Mailing address
300 STAFFORD STREET, SUITE 102, SPRINGFIELD, MA 01104
(413) 788-7321
(413) 733-6369
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110067983A
—
MA
01
—
M12721
BLUE CROSS
MA
Enumeration date
10/10/2005
Last updated
08/22/2018
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