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Individual

DR. THERESA S. RUTLEDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
300 S PRICE ST, KINGWOOD, WV 26537-1442
(304) 329-1400
(304) 329-1175
Mailing address
300 S PRICE ST, KINGWOOD, WV 26537-1442
(304) 329-1400
(304) 329-1175

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2281
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001990080
BCBS
WV
05
3810006728
WV
Enumeration date
04/04/2007
Last updated
11/17/2011
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