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Individual

VALERI A. RUSCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
230 MICHIGAN ST NE, SUITE 300, GRAND RAPIDS, MI 49503-2550
(616) 459-7101
Mailing address
1111 LEFFINGWELL AVE NE, GRAND RAPIDS, MI 49525-6406
(616) 459-7101

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
5601004845
MI
363AS0400X
Surgical Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00398254
RAILROAD MEDICARE
MI
Enumeration date
12/27/2006
Last updated
08/06/2014
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