National Provider Identifier Database

DOUGLAS W RUSNACK, MD – NPI #1336101005
Diagnostic Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Contact Information

DOUGLAS W RUSNACK, MD
601 FRONT AVENUE
SUITE #502
COEUR D'ALENE, ID  83814
Phone: 208-415-0524
Fax: 208-763-3644
Website:
Specialty Taxonomy Code
* Diagnostic Radiology 2085R0202X

* Indicates primary specialty

NPI Profile & details for DOUGLAS W RUSNACK

NPI Number 1336101005
Credentials MD
Entity Individual
Enumeration date 04/06/2006
Last updated 05/27/2009 - About 17 years ago
Sole proprietor1 Yes
Identifiers
  • ID License #: M9059
  • KY Medicaid: 7100025000
  • OH Medicaid: 2799048
  • PA Medicaid: 1019685500001
  • VA Medicaid: 010394856
  • KY Other: 000000548198 ANTHEM
  • KY Other: 50017549 PASSPORT
  • KY Other: 3425603000 PASSPORT ADVANTAGE
  • KY Other: 91732 SIHO
  • PA Other: 2501251 MEDICAL ASSISTANCE NY
  • PA Other: 2799048 MEDICAL ASSISTANCE OH
  • PA Other: 1019685500001 MEDICAL ASSISTANCE PA
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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