Individual
DAVID G RUSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7710 COMPUTER AVE, #110, EDINA, MN 55435-5417
(952) 835-9442
(952) 835-9443
Mailing address
2530 CHICAGO AVE, #550, MINNEAPOLIS, MN 55404-4289
(612) 813-8000
(612) 813-8005
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
30222
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
837782100
—
MN
Enumeration date
03/31/2006
Last updated
08/08/2012
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