Individual
DR. DANIEL B. RUKSTALIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3 RIVERSIDE CIR, ROANOKE, VA 24016-4955
(540) 224-5170
(540) 983-8212
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5715
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101275901
VA
208800000X
Urology Physician
2012-02004
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5921837
—
NC
Enumeration date
04/26/2006
Last updated
09/19/2022
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