Individual
WAYNE J RUSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 730-4950
Mailing address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 730-4950
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
31022
WI
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
31022
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31571500
—
WI
Enumeration date
09/06/2005
Last updated
09/09/2008
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