DAVID SAMIR RUSTOM (NPI# 1578054078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578054078 |
| Entity Type | Individual |
| Full Name | DAVID SAMIR RUSTOM |
| Credential | MD |
| Practice Address |
920 Madison Avenue Suite 447 Memphis TN 38163 |
| Practice Telephone | 9014485814 |
| Mailing Telephone | 9014485814 |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2018-05-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073877320 | David H Rustom | Internal Medicine | 261 Mack Ave Ste 188, Detroit, MI 48201-2417 | 2012-07-02 |
| Street Address |
920 MADISON AVENUE SUITE 447 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972827962 | David W. Jones II | Pharmacist | 920 Madison Avenue Suite 447, Memphis, TN 38163-0181 | 2010-03-18 |
| 1770103616 | Evan Shelby Tatford | Student in an Organized Health Care Education/Training Program | 920 Madison Avenue Suite 447, Memphis, TN 38163-3513 | 2020-04-21 |
| 1053930057 | Ruth Woldemichael | Student in an Organized Health Care Education/Training Program | 920 Madison Avenue Suite 447, Memphis, TN 38163-4400 | 2020-04-10 |
| 1902435837 | Emad Al Rawashdeh | Student in an Organized Health Care Education/Training Program | 920 Madison Avenue Suite 447, Memphis, TN 38163-2814 | 2020-04-03 |
| 1124654942 | Raychel Simpson | Student in an Organized Health Care Education/Training Program | 920 Madison Avenue Suite 447, Memphis, TN 38163-4210 | 2020-03-13 |
| 1477117133 | Cameron Dan Lowry | Student in an Organized Health Care Education/Training Program | 920 Madison Avenue Suite 447, Memphis, TN 38163-2807 | 2019-04-29 |
| 1801359740 | Jonathon Logan Anderson | Student in an Organized Health Care Education/Training Program | 920 Madison Avenue Suite 447, Memphis, TN 38163-4400 | 2019-04-08 |
| 1700377348 | Taylor Marie Kirby Bush | Student in an Organized Health Care Education/Training Program | 920 Madison Avenue Suite 447, Memphis, TN 38163-2494 | 2018-05-18 |
| 1629568845 | Nicholas Robert O'sick | Student in an Organized Health Care Education/Training Program | 920 Madison Avenue Suite 447, Memphis, TN 38163 | 2018-05-14 |
| 1023508249 | Scott Norman Wisniewski | Student in an Organized Health Care Education/Training Program | 920 Madison Avenue Suite 447, Memphis, TN 38163 | 2018-05-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801367537 | Stacie Nicole Yocom | Pediatrics | 853 Jefferson Ave Route E206, Memphis, TN 38163 | 2018-12-06 |
| 1639651052 | Angela Renae Haynes | Dental Hygienist | 875 Union Ave Dunn Dental Bldg C 517, Memphis, TN 38163 | 2018-09-01 |
| 1700362613 | Ibrahim Ortanca | Student in an Organized Health Care Education/Training Program | University of Tennessee 920 Madison Avenue, Suite 447 - Office of Graduate Medical Education, Memphis, TN 38163 | 2018-07-13 |
| 1619469103 | Julia Christine Cook | Student in an Organized Health Care Education/Training Program | University of Tennesee, 920 Madison Ave, Suite 447, Memphis, TN 38163 | 2018-05-31 |
| 1104359058 | Malik Fakhar | Student in an Organized Health Care Education/Training Program | 960 Madison Ave, 447, Memphis, TN 38163 | 2017-04-07 |
| 1215319322 | Yousef Abdel-aziz | Student in an Organized Health Care Education/Training Program | 956 Court Avenue Suite G310b, Memphis, TN 38163 | 2015-06-25 |
| 1770963746 | Ayman Al Dayeh | Dentist | 875 Union Ave, S312, Department of Orthodontics, Memphis, TN 38163 | 2015-06-04 |
| 1952789430 | Mark Iltis | Student in an Organized Health Care Education/Training Program | 910 Madison Ave, University of Tennessee, 1031, Memphis, TN 38163 | 2015-05-15 |
| 1700129780 | Mohammad Elballat | Student in an Organized Health Care Education/Training Program | 956 Court Ave Suite H314a, Memphis, TN 38163 | 2013-03-28 |
| 1932468204 | Evan Neal Paul | Student in an Organized Health Care Education/Training Program | 910 Madison Avenue, Suite 1031, Memphis, TN 38163 | 2012-05-08 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386252013 | Rhaina Johnson | Student in an Organized Health Care Education/Training Program | 2639 Central Ave Apt V1, Memphis, TN 38104-5954 | 2020-07-20 |
| 1821606021 | Stephanie Bell | Student in an Organized Health Care Education/Training Program | 5091 Windcrest Rd, Memphis, TN 38116-8526 | 2020-07-14 |
| 1245857077 | Melissa Rodriguez Analco | Student in an Organized Health Care Education/Training Program | 4343 Emily Ave, Memphis, TN 38122-4822 | 2020-06-27 |
| 1316564321 | Piper Black | Student in an Organized Health Care Education/Training Program | Uthsc College of Nursing 920 Madison Avenue, Memphis, TN 38163-0001 | 2020-06-26 |
| 1225654726 | Karen Y Wilson | Student in an Organized Health Care Education/Training Program | The University of Tennessee Health Science Center, 920 Madison Ave., Memphis, TN 38163-4774 | 2020-06-19 |
| 1881216356 | Asif Jamal | Student in an Organized Health Care Education/Training Program | 865 Jefferson Ave Ste F150, Memphis, TN 38103-2807 | 2020-05-07 |
| 1992325468 | Zebin Mohammad Al Zebin | Student in an Organized Health Care Education/Training Program | 288 Night Sail Dr S Apt 107, Memphis, TN 38103-1724 | 2020-04-24 |
| 1922627637 | Krystal Lugo | Student in an Organized Health Care Education/Training Program | 3940 Summer Breeze Cv, Memphis, TN 38125-2840 | 2020-04-13 |
| 1336768092 | Preeti Singh | Student in an Organized Health Care Education/Training Program | 853 Jefferson Chandler F150, Memphis, TN 38163-0001 | 2020-04-13 |
| 1588283410 | Elizabeth Chandler Lee | Student in an Organized Health Care Education/Training Program | 545 Club Walk, Memphis, TN 38111-3200 | 2020-04-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.