Individual
SARAH RUTH RUSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5315 WALL ST STE 260, MADISON, WI 53718-7937
(608) 807-1600
Mailing address
5315 WALL ST STE 260, MADISON, WI 53718-7937
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
64527-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100052321
—
WI
Enumeration date
04/27/2012
Last updated
07/01/2016
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