Provider Demographics
NPI:1639550312
Name:RUSHING, MARCUS D (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:D
Last Name:RUSHING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MARCUS
Other - Middle Name:D
Other - Last Name:RUSHING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:205 WABASHA ST S
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55107-1894
Mailing Address - Country:US
Mailing Address - Phone:651-293-8269
Mailing Address - Fax:651-293-8195
Practice Address - Street 1:205 WABASHA ST S
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55107-1894
Practice Address - Country:US
Practice Address - Phone:651-293-8269
Practice Address - Fax:651-293-8195
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125066633207Q00000X, 207ZP0102X, 390200000X
MN654032083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program