Provider Demographics
NPI:1437152808
Name:RUSCHE, ROBERT L (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:RUSCHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1230
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1230
Mailing Address - Country:US
Mailing Address - Phone:812-424-4602
Mailing Address - Fax:812-421-5147
Practice Address - Street 1:1750 OAK HILL RD
Practice Address - Street 2:STE 100
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-4364
Practice Address - Country:US
Practice Address - Phone:812-424-4602
Practice Address - Fax:812-421-5147
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01033818A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110020143OtherRAILROAD MEDICARE
IN100248050AMedicaid
110020143OtherRAILROAD MEDICARE
C25883Medicare UPIN