Russell, Dawn Marie

Russell, Dawn Marie is an individual health care provider with primary practice located at 4881 Sugar Maple Dr 88Th Medical Group, Wright Patterson Afb OH 45433-5250. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Russell, Dawn Marie can be contacted via phone (937) 257-1941.

Contact Information

Primary practice address
4881 Sugar Maple Dr 88Th Medical Group Wright Patterson Afb OH 45433-5250
Phone: (937) 257-1941
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1076380 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 50.003959 Ohio

Profile Details

NPI number 1508906116
LBN Legal business name Russell, Dawn Marie
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2007
Last updated Mar 18th, 2020 - about 4 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 1508906116 NPPES
Ohio MEDICAID 0110474

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