Russell, Dorothea D

Russell, Dorothea D is an individual health care provider with primary practice located at 2828 Chicago Ave South Suite 200, Minneapolis MN 55407-1320. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Russell, Dorothea D can be contacted via phone (612) 879-1000.

Contact Information

Primary practice address
2828 Chicago Ave South Suite 200 Minneapolis MN 55407-1320
Phone: (612) 879-1000
Fax: (612) 879-9116
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X R0611606 Minnesota

Profile Details

NPI number 1508860578
LBN Legal business name Russell, Dorothea D
Credentials RN, MS, CNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2005
Last updated Oct 21st, 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 1508860578 NPPES
Minnesota MEDICAID 303664200

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