Provider Demographics
NPI:1144856964
Name:RUSHING, DONNELL MARCELLUS (MBA)
Entity type:Individual
Prefix:MR
First Name:DONNELL
Middle Name:MARCELLUS
Last Name:RUSHING
Suffix:
Gender:M
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4208 N 52ND ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-1338
Mailing Address - Country:US
Mailing Address - Phone:414-366-0955
Mailing Address - Fax:
Practice Address - Street 1:4208 N 52ND ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-1338
Practice Address - Country:US
Practice Address - Phone:414-366-0955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)