Provider Demographics
NPI:1942232822
Name:RUSE, ERNEST A (MD)
Entity type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:A
Last Name:RUSE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1890 AL HIGHWAY 157
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35058-3601
Mailing Address - Country:US
Mailing Address - Phone:256-737-8000
Mailing Address - Fax:256-737-8058
Practice Address - Street 1:1890 AL HIGHWAY 157
Practice Address - Street 2:SUITE 300
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-3601
Practice Address - Country:US
Practice Address - Phone:256-737-8000
Practice Address - Fax:256-737-8058
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-02-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL00027474207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009938043Medicaid
NJH94258Medicare UPIN
051535510Medicare PIN