Healthcare Provider Details

I. General information

NPI: 1053385104
Provider Name (Legal Business Name): RUSTY CHRISTOPHER BRAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 BELLINGER STREET
EAU CLAIRE WI
54702-1510
US

IV. Provider business mailing address

200 1ST ST SW
ROCHESTER MN
55905-0001
US

V. Phone/Fax

Practice location:
  • Phone: 715-838-6161
  • Fax: 715-838-6522
Mailing address:
  • Phone: 715-838-5222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number50471-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: