Individual
DR. RICHARD J IARUSSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5901 MONCLOVA RD, MAUMEE, OH 43537-1841
(419) 893-5911
(440) 579-0191
Mailing address
7757 AUBURN RD STE 15, CONCORD TWP, OH 44077-9604
(440) 350-0832
(440) 579-0191
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01057869
IN
207L00000X
Anesthesiology Physician
Primary
35.050894
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0634817
—
OH
01
—
163856
CSHCS
IN
01
—
163857
CSHCS
IN
01
—
189170N
INDIANA MEDICARE
IN
05
—
200476340
—
IN
01
—
P00163010
RAILROAD MEDICARE
IN
Enumeration date
07/12/2005
Last updated
01/29/2021
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