Individual
DR. ROBERT EDWARD RUST JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 N DIVISION AVE, SANDPOINT, ID 83864-8268
(208) 263-1345
(208) 255-5531
Mailing address
1301 N DIVISION AVE, SANDPOINT, ID 83864-8268
(208) 290-3567
(208) 255-5531
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
M3004
ID
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
M-3004
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112500019
—
ID
Enumeration date
12/22/2006
Last updated
10/17/2013
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