Individual
SPENCER LOUIS RUSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8901 W LINCOLN AVE, WEST ALLIS, WI 53227-2409
(414) 328-7997
Mailing address
8901 W LINCOLN AVE, WEST ALLIS, WI 53227-2409
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
0101260209
VA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
75333-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100175540
—
WI
05
—
1710278007
—
VA
Enumeration date
04/21/2011
Last updated
01/03/2022
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