Russell, Demaura H
Russell, Demaura H is an sole proprietor health care provider with primary practice located at 702 N Main St , Roxboro NC 27573-4755. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Russell, Demaura H can be contacted via phone (336) 599-9271.Contact Information
Primary practice address
702 N Main St
Roxboro NC 27573-4755
Phone: (336) 599-9271
Fax: (336) 599-0347
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 2013-01723 | North Carolina |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2013-01723 | North Carolina |
Profile Details
| NPI number | 1114218492 |
|---|---|
| LBN Legal business name | Russell, Demaura H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 21st, 2011 |
| Last updated | Feb 2nd, 2021 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114218492 | NPPES |
| North Carolina | MEDICAID | 1114218492 |
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