David Samir Rustom | Memphis, TN • PECOS Search

David Samir Rustom

Internal Medicine

Allopathic & Osteopathic Physicians

1030 Jefferson Ave, Memphis, TN 38104-2127

PECOS Enrollment

Based on the most recent information from CMS, provider David Samir Rustom does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1578054078
Provider Type
Individual
Full Name
Rustom, David Samir
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
5/21/2018
Last Updated
1/16/2024

Contact Information

Practice Location

1030 Jefferson Ave, Memphis, TN 38104-2127

Unlisted Fax

Mailing Location

1030 Jefferson Ave, Memphis, TN 38104-2127

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207RN0300X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 67863 Tennessee