Provider Demographics
NPI:1871601278
Name:RUFLETH, PETER W (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:W
Last Name:RUFLETH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3112
Mailing Address - Country:US
Mailing Address - Phone:508-771-9622
Mailing Address - Fax:508-771-9621
Practice Address - Street 1:6 MAIN ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3112
Practice Address - Country:US
Practice Address - Phone:508-771-9622
Practice Address - Fax:508-771-9621
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA52566207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3032582Medicaid
A57164Medicare UPIN
MATO4072RUMedicare ID - Type Unspecified