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General NPI Number Information
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NPI Number | 1720078108
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Entity Type | Individual
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Provider Name | ROBERT J. HRUSKOVICH MD
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Gender | Male
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 09/11/2019
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Provider Practice Location Address
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Address Line | 211 N EDDY ST.
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City | SOUTH BEND
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State | IN
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Zip | 46617-3096
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Country | US
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Telephone | 574-246-8816
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Fax | 574-204-6345
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Provider Business Mailing Address
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Address Line | 211 N EDDY ST.
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City | SOUTH BEND
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State | IN
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Zip | 46617-3096
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Country | US
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Telephone | 574-246-8816
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Fax | 574-204-6345
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 52696
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301116232
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD046481
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License Number State | DC
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 15405
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License Number State | ND
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R9778
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01043972A
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License Number State | IN
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