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General NPI Number Information
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NPI Number | 1730232141
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Entity Type | Organization
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Legal Business Name | PAUL J RUSCHAK MD PC
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 100 STOOPS DR SUITE 220
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City | MONONGAHELA
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State | PA
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Zip | 15063-3553
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Country | US
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Telephone | 724-483-5507
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Fax | 724-483-0530
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Provider Business Mailing Address
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Address Line | 100 STOOPS DR SUITE 220
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City | MONONGAHELA
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State | PA
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Zip | 15063-3553
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Country | US
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Telephone | 724-483-5507
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Fax | 724-483-0530
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Authorized Official
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Title or Position | OWNER DERMATOLOGIST
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Name | DR. PAUL J RUSCHAK
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Credential | MD
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Telephone | 724-483-5507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD017990E
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License Number State | PA
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