Russell, Michael
Russell, Michael is an sole proprietor health care provider with primary practice located at 4588 N 23Rd St , Milwaukee WI 53209-6201. He recently has only one registered license in Transportation Services / Non-emergency Medical Transport (VAN), which is considered as his primary health care specialty. Russell, Michael can be contacted via phone (414) 477-4978.Contact Information
Primary practice address
4588 N 23Rd St
Milwaukee WI 53209-6201
Phone: (414) 477-4978
Fax: (414) 445-1515
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Transportation Services / Non-emergency Medical Transport (VAN) | 343900000X | 41487100 | Wisconsin |
Profile Details
| NPI number | 1245414093 |
|---|---|
| LBN Legal business name | Russell, Michael |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 27th, 2007 |
| Last updated | Dec 27th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245414093 | NPPES |
| Wisconsin | MEDICAID | 41487100 |
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