Russell, Mary Louise
Russell, Mary Louise is an individual health care provider with primary practice located at 1405 Shady Ave , Pittsburgh PA 15217-1350. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is her primary health care specialty. Russell, Mary Louise can be contacted via phone (412) 420-2270.Contact Information
Primary practice address
1405 Shady Ave
Pittsburgh PA 15217-1350
Phone: (412) 420-2270
Fax: (412) 420-4450
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD044119E | Pennsylvania |
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | MD044119E | Pennsylvania |
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 29378 | West Virginia |
Profile Details
NPI number | 1184691222 |
---|---|
LBN Legal business name | Russell, Mary Louise |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 8th, 2006 |
Last updated | Apr 12th, 2022 - about 2 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 | 1184691222 | NPPES |
Pennsylvania | MEDICAID | 1170159 |
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