Dr. Walter Kenneth Rush IV, M.D.
Psychiatry & Neurology, Psychiatry in Saint Paul, MN. Individual provider (NPI-1).
NPI number1003907155
StatusActive
Last updated in NPPESMar 7, 2023
Details
- NPI
- 1003907155
- Entity type
- Individual (NPI-1)
- Name
- Dr. Walter Kenneth Rush IV
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 27, 2006
- Last updated
- Mar 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | 45379 | MN | Yes |
Practice location
275 4th St ESaint Paul, MN 55101-1696
Phone 651-389-4690 · Fax 651-389-4691
Mailing address
275 4th St ESaint Paul, MN 55101-1696
Phone 651-389-4690 · Fax 651-389-4691
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