Individual
GARY DALE RUSK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3903 S 7TH ST, SUITE 2D, TERRE HAUTE, IN 47802-5710
(812) 232-2100
(812) 232-1980
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01039496
IN
2084N0400X
Neurology Physician
Primary
01039496
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200089010A
—
IN
Enumeration date
08/12/2005
Last updated
05/18/2022
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