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General NPI Number Information
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NPI Number | 1790813269
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Entity Type | Organization
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Legal Business Name | RUSH MEDICAL ARTS GROUP, PC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 323 CONRAD HARCOURT WAY
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City | RUSHVILLE
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State | IN
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Zip | 46173-1161
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Country | US
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Telephone | 765-932-4441
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Fax | 765-932-4906
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Provider Business Mailing Address
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Address Line | PO BOX 127
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City | RUSHVILLE
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State | IN
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Zip | 46173-0127
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Country | US
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Telephone | 765-932-4441
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Fax | 765-932-4906
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHERIF M SHAMAA
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Credential | M.D.
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Telephone | 765-932-4441
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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 |
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License Number State |
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