Individual
DR. JENNIFER L RUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5544 GREENWICH RD STE 200, VIRGINIA BEACH, VA 23462-6563
(757) 466-0089
(757) 466-8017
Mailing address
5544 GREENWICH RD STE 200, VIRGINIA BEACH, VA 23462-6563
(757) 466-0089
(757) 466-8017
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
0102201777
VA
2085R0202X
Diagnostic Radiology Physician
Primary
0102201777
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001531
SENTARA
VA
01
—
139178
BCBS
VA
05
—
1609850882
—
VA
05
—
5901860
—
NC
01
—
P00406321
RR MEDICARE
VA
Enumeration date
12/01/2005
Last updated
02/07/2014
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