Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD058670L | PA |
NPI | 1144333154 |
---|---|
Provider Name | Orion Rust |
First Address | Philadelphia, PA 19178-3311 |
Second Address | Allentown, PA 18103-6122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 16/03/2016 |