David G Rustad, MD | |
7710 Computer Ave, #110, Edina, MN 55435-5417 | |
(952) 835-9442 | |
(952) 835-9443 |
Full Name | David G Rustad |
---|---|
Gender | Male |
Speciality | Surgery - Pediatric Surgery |
Location | 7710 Computer Ave, Edina, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013978568 | NPI | - | NPPES |
837782100 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2086S0120X | Surgery - Pediatric Surgery | 30222 (Minnesota) | Primary |
Entity Name | Pediatric Surgical Associates Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093778292 PECOS PAC ID: 3678477544 Enrollment ID: O20031121000636 |
Mailing Address | Practice Location Address |
---|---|
David G Rustad, MD 2530 Chicago Ave, #550, Minneapolis, MN 55404-4289 Ph: (612) 813-8000 | David G Rustad, MD 7710 Computer Ave, #110, Edina, MN 55435-5417 Ph: (952) 835-9442 |
James H. Andrisevic, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 4570 W 77th St, Suite 235, Edina, MN 55435 Phone: 952-832-0805 Fax: 952-832-5597 | |
Paul L. Benn, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 6405 France Ave S, Suite W440, Edina, MN 55435 Phone: 952-927-7004 Fax: 952-927-5146 | |
Dr. Jonathan David Witzke, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 7450 France Ave S Ste 220, Edina, MN 55435 Phone: 952-925-1111 Fax: 952-922-3446 | |
Charles P. Nicholson, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 6405 France Ave S, Suite W440, Edina, MN 55435 Phone: 952-927-7004 Fax: 952-927-5146 | |
Dr. Robert Joseph Reese, DO Surgery Medicare: Not Enrolled in Medicare Practice Location: 6525 France Ave S, Suite, Edina, MN 55435 Phone: 803-808-8070 Fax: 803-808-8074 | |
George J. Nemanich, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 6405 France Ave S, Suite W440, Edina, MN 55435 Phone: 952-927-7004 Fax: 952-927-5146 |