Individual
LAERT RUSHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11 FRIENDSHIP ST, NEWPORT, RI 02840-2209
(401) 845-1190
(401) 845-1073
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
MD17009
RI
Other
Enumeration date
03/25/2015
Last updated
05/08/2020
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