Individual
LEE STUART RUSAKOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4545 E 9TH AVE, SUITE 504, DENVER, CO 80220-3901
(303) 831-9853
(303) 832-3533
Mailing address
4545 E 9TH AVE, SUITE 504, DENVER, CO 80220-3901
(303) 831-9853
(303) 832-3533
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
29525
CO
2080P0214X
Pediatric Pulmonology Physician
72381
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2004704000
MEDICAID
WV
05
—
2252093
—
OH
01
—
64034978
MEDICAID
KY
Enumeration date
09/27/2005
Last updated
05/09/2025
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