Individual
DR. MARK S RUTTUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9000 W WISCONSIN AVE, PEDIATRIC OPHTHALMOLOGY, MILWAUKEE, WI 53226-4874
(414) 266-2020
(414) 266-2027
Mailing address
9000 W WISCONSIN AVE, PEDIATRIC OPHTHALMOLOGY, MILWAUKEE, WI 53226-4874
(414) 266-2020
(414) 266-2027
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
21829
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000140V
HUMANA
—
05
—
1801848585
—
WI
Enumeration date
05/17/2006
Last updated
09/24/2014
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