| Paul M Rutkowski Do Pc | |
|
540 Pierce St Kingston PA 18704-5760 | |
| (570) 285-3570 | |
| (570) 285-3572 |
| Full Name | Paul M Rutkowski Do Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 540 Pierce St, Kingston, Pennsylvania |
| Authorized Official Name and Position | Paul M Rutkowski (PRESIDENT) |
| Authorized Official Contact | 5702853570 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul M Rutkowski Do Pc Po Box 1388 Kingston PA 18704-0379 Ph: (570) 288-8881 | Paul M Rutkowski Do Pc 540 Pierce St Kingston PA 18704-5760 Ph: (570) 285-3570 |
| NPI Number | 1164875464 |
|---|---|
| Provider Enumeration Date | 07/21/2016 |
| Last Update Date | 04/30/2024 |
| Medicare PECOS PAC ID | 6608163746 |
|---|---|
| Medicare Enrollment ID | O20160917000247 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164875464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | OS015467 (Pennsylvania) | Primary |
| Provider Name | Paul M Rutkowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003078254 PECOS PAC ID: 0840321741 Enrollment ID: I20120503000303 |
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