Individual
SCOTT RUTCHIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
410 PARK PL STE B, MISHAWAKA, IN 46545-3557
(574) 855-5800
(574) 855-5805
Mailing address
PO BOX 2968, ELKHART, IN 46515-2968
(574) 296-3200
(574) 296-3392
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01057389
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021236800
FEDERAL BLACK LUNG
IN
05
—
200443540
—
IN
01
—
P00038154
MEDICARE RAILROAD
IN
Enumeration date
05/23/2006
Last updated
09/04/2008
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