Individual
MICHAEL P RUSNAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9773
(970) 493-0112
Mailing address
2500 E PROSPECT ROAD, FORT COLLINS, CO 80525-9773
(970) 493-0112
Taxonomy
Speciality
Code
Description
License number
State
207XX0801X
Orthopaedic Trauma Physician
Primary
DR.0046798
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255521563
—
WY
05
—
98508806
—
CO
01
—
P00645247
RR MEDICARE
CO
Enumeration date
08/01/2007
Last updated
12/16/2019
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