Provider Demographics
NPI:1285681320
Name:RUS, VIOLETA (MD)
Entity Type:Individual
Prefix:DR
First Name:VIOLETA
Middle Name:
Last Name:RUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64442
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4442
Mailing Address - Country:US
Mailing Address - Phone:410-706-6474
Mailing Address - Fax:410-706-0231
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-706-6474
Practice Address - Fax:410-706-0231
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD51494207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD3678024000Medicaid
MD707993-01OtherBLUE CROSS/BLUE SHIELD
G77273Medicare UPIN
MD3678024000Medicaid
MDS483217YMedicare PIN