Individual
SANDRA R RUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6 HOSPITAL PLZ, CLARKSBURG, WV 26301
(304) 623-5661
(304) 623-2180
Mailing address
6 HOSPITAL PLZ, CLARKSBURG, WV 26301
(304) 623-5661
(304) 623-2180
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19709
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001721679
BCBS
WV
05
—
1804022000
—
WV
Enumeration date
09/13/2006
Last updated
12/20/2016
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