Matthew William Ruble, M.D.
Individual provider Active NPI Psychiatry Physician · Provincetown, MA
NPI 1972501302 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1972501302
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 208742 (MA)
- Practice address
- 30 Conwell St
Provincetown, MA 02657-1548 - Phone
- (508) 487-1459
- Fax
- (508) 349-0966
- NPI assigned
- Jul 11, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Common Ground Counseling & Personal Growth Center, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 208742 | MA | Yes |
Addresses
Primary practice location
30 Conwell St
Provincetown, MA 02657-1548
Mailing address
PO Box 964
Truro, MA 02666-0964
Phone (508) 349-9661
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0125181 | Medicaid | MA |
Other providers in Provincetown, MA
- Joan E Prugh
- Quest Diagnostics Massachusetts LLC
- Walter M Richter
- Aneta Roderick
- Susan H. Roderick
- Jonathan Scott Runge
- Piotr Sapinski
- Mark Edward Schiffman
- Seashore Point
- Seashore Point - Deaconess Inc
All providers in Provincetown, MA · Psychiatry Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.