Rustin, Rudolph B.

Rustin, Rudolph B. is an individual health care provider with primary practice located at 1300 Jefferson Park Ave 4Th Floor, Charlottesville VA 22903-3363. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Rustin, Rudolph B. can be contacted via phone (434) 982-4411.

Contact Information

Primary practice address
1300 Jefferson Park Ave 4Th Floor Charlottesville VA 22903-3363
Phone: (434) 982-4411
Fax: (434) 924-2260
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 14302 South Carolina
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 14302 South Carolina
Allopathic & Osteopathic Physicians / Surgery 208600000X 0101258483 Virginia

Profile Details

NPI number 1679548614
LBN Legal business name Rustin, Rudolph B.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 22nd, 2006
Last updated Sep 9th, 2016 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679548614 NPPES
Virginia MEDICAID 1679548614
Virginia MEDICAID 143026

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