Provider Demographics
NPI:1063523702
Name:WEEKS, RUTHELLEN DENISE (MD)
Entity type:Individual
Prefix:
First Name:RUTHELLEN
Middle Name:DENISE
Last Name:WEEKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16354-2152
Mailing Address - Country:US
Mailing Address - Phone:814-827-7229
Mailing Address - Fax:814-827-4869
Practice Address - Street 1:602 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16354-2152
Practice Address - Country:US
Practice Address - Phone:814-827-7229
Practice Address - Fax:814-827-4869
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA029120E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000065772OtherHIGHMARK
PA0009081980002Medicaid
PA251597OtherUPMC
E63510Medicare UPIN
PA0009081980002Medicaid