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Individual

MICHAEL RUSAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-3100
Mailing address
3100 SPRING FOREST RD, STE 130, RALEIGH, NC 27616-2880
(919) 873-9533

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
81313
NC
367500000X
Certified Registered Nurse Anesthetist
RN547485
PA

Other

Enumeration date
12/29/2008
Last updated
11/11/2014
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