Russell, Roger Bivins
Russell, Roger Bivins is an individual health care provider with primary practice located at 3633 Harden Rd Ste 200, Raleigh NC 27607-3369. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Russell, Roger Bivins can be contacted via phone (919) 785-0505.Contact Information
Primary practice address
3633 Harden Rd Ste 200
Raleigh NC 27607-3369
Phone: (919) 785-0505
Fax: (919) 785-0205
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | 27515 | North Carolina |
Profile Details
NPI number | 1588668529 |
---|---|
LBN Legal business name | Russell, Roger Bivins |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 8th, 2005 |
Last updated | Dec 29th, 2010 - about 15 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 | 1588668529 | NPPES |
North Carolina | Other | 74061 | BCBS |
North Carolina | MEDICAID | 8974061 | BCBS |
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