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Organization
RUSTICO B. ORTIZ, M.D.P.C.
Active
Organization
RUSTICO B. ORTIZ, M.D.P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSTICO B ORTIZ M.D. (PRESIDENT)
(989) 793-4420
Entity
Organization
Contact information
Practice address
3150 HALLMARK CT, SAGINAW, MI 48603-2173
(989) 793-4420
(989) 793-8577
Mailing address
3150 HALLMARK CT, SAGINAW, MI 48603-2173
(989) 793-4420
(989) 793-8577
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
RO032199
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1036714
—
MI
01
—
1107398752
BLUE CROSS BLUE SHIELD
MI
Enumeration date
05/11/2006
Last updated
08/22/2020
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