Individual
THOMAS N RUSK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1012 UNION ST, BANGOR, ME 04401
(207) 945-5247
(207) 990-1248
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 945-5247
(207) 947-0435
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
015579
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201832
MEDICARE FQHC
ME
05
—
296240099
—
ME
Enumeration date
09/13/2006
Last updated
10/10/2011
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