Healthcare Provider Details

I. General information

NPI: 1790505303
Provider Name (Legal Business Name): MARCUS RUSHING MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2024
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2785 E GRAND BLVD
DETROIT MI
48211-2003
US

IV. Provider business mailing address

1144 S DETROIT AVE UNIT 141184
TOLEDO OH
43614-8342
US

V. Phone/Fax

Practice location:
  • Phone: 313-473-9321
  • Fax: 313-557-1957
Mailing address:
  • Phone: 313-473-9321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARCUS RUSHING
Title or Position: OPERATING MANAGER
Credential: MD, MPH, MS
Phone: 313-473-9321