Individual
PHYLLIDIA M. KU-RUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
84 MARGINAL WAY, SUITE 800, PORTLAND, ME 04101-2443
(207) 774-5816
(207) 774-7831
Mailing address
100 GANNETT DR STE C, SOUTH PORTLAND, ME 04106-5900
(207) 347-2947
(207) 874-2317
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
015348
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061137
ANTHEM
—
01
—
2456790
AETNA
—
05
—
309140099
—
ME
Enumeration date
03/15/2006
Last updated
03/04/2026
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