Mader, Russell David

Mader, Russell David is an individual health care provider with primary practice located at 2300 W Stone Dr , Kingsport TN 37660-2360. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Mader, Russell David can be contacted via phone (423) 246-4961.

Contact Information

Primary practice address
2300 W Stone Dr Kingsport TN 37660-2360
Phone: (423) 246-4961
Fax: (423) 245-3136
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X MD0000030476 Tennessee

Profile Details

NPI number 1871571182
LBN Legal business name Mader, Russell David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 6th, 2006
Last updated Oct 24th, 2007 - about 17 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.

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