Provider Demographics
NPI:1417115544
Name:RUSH, STEPHANIE S (DO)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:S
Last Name:RUSH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 EMBARCADERO CTR STE 1900
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-3723
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:415-520-0904
Practice Address - Street 1:1827 ADAMS MILL RD NW STE C
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2399
Practice Address - Country:US
Practice Address - Phone:202-627-1903
Practice Address - Fax:202-660-0025
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCDO034894207Q00000X
TXN3281207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine