Provider Demographics
NPI:1437590296
Name:MOME, RUTH KERNYUY BAME (MD)
Entity type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:KERNYUY BAME
Last Name:MOME
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:RUTH
Other - Middle Name:KERNYUY
Other - Last Name:BAME
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:405 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:PELLA
Mailing Address - State:IA
Mailing Address - Zip Code:50219-1290
Mailing Address - Country:US
Mailing Address - Phone:641-628-6610
Mailing Address - Fax:
Practice Address - Street 1:405 MONROE ST
Practice Address - Street 2:
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219-1290
Practice Address - Country:US
Practice Address - Phone:641-628-6610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-43122207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine