Russell, Gregory D.

Russell, Gregory D. is an individual health care provider with primary practice located at 49 State Rd , North Dartmouth MA 02747-3322. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Russell, Gregory D. can be contacted via phone (508) 973-6650.

Contact Information

Primary practice address
49 State Rd North Dartmouth MA 02747-3322
Fax: (508) 973-0345
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 150866 Massachusetts

Profile Details

NPI number 1053365163
LBN Legal business name Russell, Gregory D.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2006
Last updated Apr 24th, 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 1053365163 NPPES
Massachusetts MEDICAID 110059962A

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