Individual
DR. WILLARD D RUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1870 WHITEHAVEN RD, GRAND ISLAND, NY 14072-1804
(716) 773-6181
(716) 773-0941
Mailing address
1870 WHITEHAVEN RD, GRAND ISLAND, NY 14072-1804
(716) 773-6181
(716) 773-0941
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
108855
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010152701
UNIVERA
—
01
—
00050366101
BCBS
—
05
—
00629290
—
NY
01
—
6400427
IHA
—
Enumeration date
10/02/2006
Last updated
07/08/2007
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