Provider Demographics
NPI:1447694328
Name:RUSH, PATRICK STEPHEN (DO)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:STEPHEN
Last Name:RUSH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 HIGHLAND AVE. H4/831
Mailing Address - Street 2:UW HOSPITAL AND CLINICS
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53792
Mailing Address - Country:US
Mailing Address - Phone:608-262-7158
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE. H4/831
Practice Address - Street 2:UW HOSPITAL AND CLINICS
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792
Practice Address - Country:US
Practice Address - Phone:608-262-7158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-23
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI63668207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology