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NPI Code Detail

MEDICARE: DR. GEORGE STABEN RUST MD

MEDICARE: DR. GEORGE STABEN RUST MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12083P0901XPublic Health & General Preventive Medicine PhysicianME46256FL
2207Q00000XFamily Medicine PhysicianME46256FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346376308
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE STABEN RUST MD
Provider Business Mailing Address
First Line : 1115 W CALL ST
Second Line : FSU-COM, DEPT OF BSSM
City : TALLAHASSEE
State : FL
Zip : 32304-3556
Country : US
Telephone Number : 850-644-1543
Fax Number :
Provider Business Practice Location Address
First Line : 2911 ROBERTS AVE
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32310-5007
Country : US
Telephone Number : 850-644-1543
Fax Number : 855-230-7421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2007
Last Update Date : 01/14/2021

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Directions to “ DR. GEORGE STABEN RUST MD” Practice Location

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