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Individual

KONSTANTIN I RUSIN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3990 JOHN R ST, DETROIT, MI 48201-2018
(313) 745-8521
Mailing address
744 W MICHIGAN AVE, JACKSON, MI 49201-1909
(517) 787-6440
(517) 787-4146

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301071917

Other

Enumeration date
06/10/2006
Last updated
07/08/2007
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