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, MPH, MS
Mailing Address - Street 1:1144 S DETROIT AVE UNIT 141184
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-8342
Mailing Address - Country:US
Mailing Address - Phone:313-473-9321
Mailing Address - Fax:313-557-1957
Practice Address - Street 1:2785 E GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48211-2003
Practice Address - Country:US
Practice Address - Phone:313-473-9321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125066633207Q00000X, 207ZP0102X, 390200000X
MN654032083X0100X
MI43015097622083X0100X
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