Individual
RUDOLF OTRUSINIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 N 500 E, SUITE 320, LOGAN, UT 84341-2408
(435) 755-8200
(435) 752-6094
Mailing address
PO BOX 27128, SLC, UT 84127-0128
(435) 755-8200
(435) 752-6094
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
95-292310-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060053972
RR MEDICARE
UT
01
—
107008634101
SELECTCARE
UT
01
—
53687
PEHP
UT
01
—
581997
DMBA
UT
05
—
805433000
—
ID
01
—
87-0569381
TAX ID
UT
Enumeration date
08/21/2006
Last updated
08/13/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us