Basic Information
Provider Information
NPI: 1699765883
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RUTHERFORD
FirstName: ANNA
MiddleName: ELIZABETH
NamePrefix: DR.
NameSuffix:  
Credential: MD, MPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
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Mailing Information
Address1: 75 FRANCIS ST
Address2: DIVISION OF GASTROENTEROLOGY, HEPATOLOGY & ENDOSCOPY
City: BOSTON
State: MA
PostalCode: 021156110
CountryCode: US
TelephoneNumber: 6177326389
FaxNumber: 6175660338
Practice Location
Address1: 75 FRANCIS ST
Address2: DIVISION OF GASTROENTEROLOGY, HEPATOLOGY & ENDOSCOPY
City: BOSTON
State: MA
PostalCode: 021156110
CountryCode: US
TelephoneNumber: 6177326389
FaxNumber: 6175660338
Other Information
ProviderEnumerationDate: 10/27/2005
LastUpdateDate: 05/07/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X217082MAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RG0100X217082MAY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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