Donnelly, Russell D
Donnelly, Russell D is an individual health care provider with primary practice located at 94 South St , Southbridge MA 01550-4000. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Donnelly, Russell D can be contacted via phone (508) 764-2772.Contact Information
Primary practice address
94 South St
Southbridge MA 01550-4000
Phone: (508) 764-2772
Fax: (508) 764-2833
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | LT-3003 | New Hampshire |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | MD19308 | Maine |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 56088 | Massachusetts |
Profile Details
| NPI number | 1780672105 |
|---|---|
| LBN Legal business name | Donnelly, Russell D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 10th, 2005 |
| Last updated | Dec 18th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780672105 | NPPES |
| Maine | MEDICAID | 1780672105 |
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