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NPI Code Detail

MEDICARE: MR. ROBERT J RUSKIEWICZ MD

MEDICARE: MR. ROBERT J RUSKIEWICZ 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
12084P0800XPsychiatry Physician27783020WI

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 : 1639185564
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT J RUSKIEWICZ MD
Provider Business Mailing Address
First Line : 1040 S 70TH STREET
Second Line :
City : MILWAUKEE
State : WI
Zip : 53214
Country : US
Telephone Number : 414-476-9675
Fax Number : 414-615-0627
Provider Business Practice Location Address
First Line : 2020 W WELLS ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53233-2720
Country : US
Telephone Number : 414-476-9675
Fax Number : 414-755-1834
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 11/05/2024

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