Rusnack, Douglas William
Rusnack, Douglas William is an sole proprietor health care provider with primary practice located at 601 Front Avenue Suite #502, Coeur D Alene ID 83814. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Rusnack, Douglas William can be contacted via phone (208) 415-0524.Contact Information
Primary practice address
601 Front Avenue Suite #502
Coeur D Alene ID 83814
Phone: (208) 415-0524
Fax: (208) 763-3644
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | M9059 | Idaho |
Profile Details
| NPI number | 1336101005 |
|---|---|
| LBN Legal business name | Rusnack, Douglas William |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 6th, 2006 |
| Last updated | May 27th, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336101005 | NPPES |
| Virginia | MEDICAID | 010394856 | |
| Virginia | Other | 2799048 | |
| Virginia | Other | 50017549 | |
| Virginia | Other | 1019685500001 | |
| Virginia | MEDICAID | 2799048 | |
| Virginia | Other | 000000548198 | |
| Virginia | MEDICAID | 1019685500001 | |
| Virginia | Other | 2501251 | |
| Virginia | Other | 3425603000 | |
| Virginia | MEDICAID | 7100025000 | |
| Virginia | Other | 91732 |
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