Provider Demographics
NPI:1902139645
Name:RUSH, ROSALIND (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSALIND
Middle Name:
Last Name:RUSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1592 OLD GRAVIOS ROAD
Mailing Address - Street 2:
Mailing Address - City:HIGH RIDGE
Mailing Address - State:MO
Mailing Address - Zip Code:63049
Mailing Address - Country:US
Mailing Address - Phone:636-677-1100
Mailing Address - Fax:636-376-9910
Practice Address - Street 1:1592 OLD GRAVIOS ROAD
Practice Address - Street 2:
Practice Address - City:HIGH RIDGE
Practice Address - State:MO
Practice Address - Zip Code:63049-2605
Practice Address - Country:US
Practice Address - Phone:636-677-1100
Practice Address - Fax:636-376-9910
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36443282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital