Basic Information
| Provider Information | |||||||||
| NPI: | 1154748200 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUS | ||||||||
| FirstName: | KRZYSZTOF | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 725 | ||||||||
| Address2: | |||||||||
| City: | COOPERSTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 133260725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6075473456 | ||||||||
| FaxNumber: | 6075476612 | ||||||||
| Practice Location | |||||||||
| Address1: | 3400 MINISTRY PKWY | ||||||||
| Address2: | |||||||||
| City: | WESTON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544765220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7153933000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2014 | ||||||||
| LastUpdateDate: | 10/16/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 69738-20 | WI | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.