| Michele J. Rusin, Ph.d Pc | |
|
1776 Briarcliff Rd Ne Atlanta GA 30306-2106 | |
| (404) 558-3639 | |
| Not Available |
| Full Name | Michele J. Rusin, Ph.d Pc |
|---|---|
| Speciality | Psychologist |
| Location | 1776 Briarcliff Rd Ne, Atlanta, Georgia |
| Authorized Official Name and Position | Kenneth Warner (BILLING ADMINISTRATOR) |
| Authorized Official Contact | 7704581594 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michele J. Rusin, Ph.d Pc Po Box 133207 Atlanta GA 30333-3207 Ph: (404) 558-3639 | Michele J. Rusin, Ph.d Pc 1776 Briarcliff Rd Ne Atlanta GA 30306-2106 Ph: (404) 558-3639 |
| NPI Number | 1396924692 |
|---|---|
| Provider Enumeration Date | 11/02/2007 |
| Last Update Date | 11/02/2007 |
| Medicare PECOS PAC ID | 4284622275 |
|---|---|
| Medicare Enrollment ID | O20040506000622 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396924692 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TR0400X | Psychologist - Rehabilitation | 1078 (Georgia) | Primary |
| Provider Name | Michele Jean Rusin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649349689 PECOS PAC ID: 0143487231 Enrollment ID: I20120201000219 |
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