Individual
DR. MARK D RUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
9200 W WISCONSIN AVE, DEPT OF PLASTIC SURGERY, MILWAUKEE, WI 53226-3522
(414) 805-5476
(414) 805-5850
Mailing address
9200 W WISCONSIN AVE, DEPT OF PLASTIC SURGERY, MILWAUKEE, WI 53226-3522
(414) 805-5476
(414) 805-5850
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1105
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000105
HUMANA
—
05
—
1881640043
—
WI
Enumeration date
05/26/2006
Last updated
08/22/2014
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