Russell, Debra

Russell, Debra is an sole proprietor health care provider with primary practice located at 18697 Bagley Rd , Middleburg Heights OH 44130-3417. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Russell, Debra can be contacted via phone (440) 816-8000.

Contact Information

Primary practice address
18697 Bagley Rd Middleburg Heights OH 44130-3417
Phone: (440) 816-8000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 35052790W Ohio

Profile Details

NPI number 1902847528
LBN Legal business name Russell, Debra
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 8th, 2006
Last updated Jul 8th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1902847528 NPPES
Ohio Other 930076090 MEDICARE RR-GA
Ohio Other 942460636369 MEDICARE RR-GA
Ohio MEDICAID 0689705 MEDICARE RR-GA

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