Rudolf Otrusinik
Internist - Cardiovascular Disease
1300 N 500 E Suite 320
Logan
, Utah 84341-2408
Rudolf Otrusinik
Internist - Cardiovascular Disease
1300 N 500 E Suite 320
Logan
, Utah 84341-2408
(435) 752-6094
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About
Features
Specialties
- Internist - Cardiovascular Disease
Languages spoken
- English
Location
First Address
- Rudolf Otrusinik
- Po Box 27128
- Slc, UT
- Zip : 84127-0128
- Fax : (435) 752-6094
- Phone : (435) 755-8200
Second Address
- Rudolf Otrusinik
- 1300 N 500 E Suite 320
- Logan, UT
- Zip : 84341-2408
- Fax : (435) 752-6094
- Phone : (435) 755-8200
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RC0000X | Internist - Cardiovascular Disease | 95-292310-1205 | UT |
National Provider Identifier
| NPI | 1003922394 |
|---|---|
| Provider Name | Rudolf Otrusinik |
| First Address | Slc, UT 84127-0128 |
| Second Address | Logan, UT 84341-2408 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/08/2006 |
| Last Update Date | 13/08/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 060053972 | RR MEDICARE (01) | UT |
| 107008634101 | SELECTCARE (01) | UT |
| 53687 | PEHP (01) | UT |
| 581997 | DMBA (01) | UT |
| 805433000 | (05) | ID |
| 87-0569381 | TAX ID (01) | UT |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.