Rustad, Olaf Jonathan
Rustad, Olaf Jonathan is an individual health care provider with primary practice located at 4480 Centerville Road , White Bear Lake MN 55127-3674. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Rustad, Olaf Jonathan can be contacted via phone (651) 484-2724.Contact Information
Primary practice address
4480 Centerville Road
White Bear Lake MN 55127-3674
Phone: (651) 484-2724
Fax: (651) 484-2723
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 1938363 | Minnesota |
Profile Details
| NPI number | 1174586440 |
|---|---|
| LBN Legal business name | Rustad, Olaf Jonathan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 8th, 2006 |
| Last updated | Sep 29th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174586440 | NPPES |
| Other | 070003227 | RR MEDICARE PIN |
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