Provider Demographics
NPI:1861609091
Name:RUTHERFORD, MOLLY STEWART (MD)
Entity type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:STEWART
Last Name:RUTHERFORD
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1234 FRANKLIN RD SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4606
Mailing Address - Country:US
Mailing Address - Phone:540-283-6077
Mailing Address - Fax:540-283-6098
Practice Address - Street 1:1234 FRANKLIN RD SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4606
Practice Address - Country:US
Practice Address - Phone:540-283-6077
Practice Address - Fax:540-283-6098
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2014-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101241680207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1861609091Medicare PIN