Russell, Bertram Royce

Russell, Bertram Royce is an individual health care provider with primary practice located at 701 E Marshall St , West Chester PA 19380-4412. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Russell, Bertram Royce can be contacted via phone (610) 431-5132.

Contact Information

Primary practice address
701 E Marshall St West Chester PA 19380-4412
Phone: (610) 431-5132
Fax: (610) 363-9892
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD020168E Pennsylvania

Profile Details

NPI number 1386664407
LBN Legal business name Russell, Bertram Royce
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Dec 10th, 2008 - about 16 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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Identifiers

StateTypeNumberIssuer
All States NPI 1386664407 NPPES
Pennsylvania MEDICAID 000741496

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