Ruston Keller, is a
Student In An Organized Health Care Education/training Program physician based in Detroit, Michigan. Ruston Keller is licensed to practice in Michigan (license number 4351053968) and his current practice location is 2799 W Grand Blvd, Detroit, Michigan. He can be reached at his office (for appointments etc.) via phone at
(313) 916-1601.
NPI number for Ruston Keller is 1679376792 and his current mailing address is 2799 W Grand Blvd, Detroit, Michigan. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1679376792.
Physician's Profile
| Full Name | Ruston Keller |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 2799 W Grand Blvd, Detroit, Michigan |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1679376792
- Provider Enumeration Date: 04/01/2025
- Last Update Date: 04/03/2025
Medical Identifiers
Medical identifiers for Ruston Keller such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1679376792 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208600000X | Surgery | 4351053968 (Michigan) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | 4351053968 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ruston Keller is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ruston Keller,
2799 W Grand Blvd,
Detroit, MI 48202-2608
Ph: (313) 916-1601 | Ruston Keller,
2799 W Grand Blvd,
Detroit, MI 48202-2689
Ph: (313) 916-1601 |
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