Provider Demographics
NPI:1891846564
Name:RUSK, AIMEE J (MD)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:J
Last Name:RUSK
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 1:2753 OBSERVATORY AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-2231
Mailing Address - Country:US
Mailing Address - Phone:513-282-4808
Mailing Address - Fax:513-275-6804
Practice Address - Street 1:2753 OBSERVATORY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-2231
Practice Address - Country:US
Practice Address - Phone:513-282-4808
Practice Address - Fax:513-275-6704
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0563652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000031459OtherANTHEM
OH033107000OtherMAGELLAN BEHAVIORAL HEALT