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Individual

DR. WALTER KENNETH RUSH IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
275 4TH ST E, SAINT PAUL, MN 55101-1696
(651) 389-4690
(651) 389-4691
Mailing address
275 4TH ST E, SAINT PAUL, MN 55101-1696
(651) 389-4690
(651) 389-4691

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
45379
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4400606
MN
Enumeration date
09/27/2006
Last updated
03/07/2023
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