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Individual

DR. RUTHVEN A. WODELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
233 E LANCASTER AVE, SUITE200, ARDMORE, PA 19003-2321
(610) 642-1643
(610) 642-0245
Mailing address
233 E LANCASTER AVE, SUITE200, ARDMORE, PA 19003-2321
(610) 642-1643
(610) 642-0245

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
MD027612E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
086078
HIGHMARK PIN
PA
Enumeration date
05/24/2006
Last updated
03/18/2008
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