Russell, Sandra K

Russell, Sandra K is an individual health care provider with primary practice located at 2104 Jolly Rd Suite 220, Okemos MI 48864-6043. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Russell, Sandra K can be contacted via phone (517) 975-1400.

Contact Information

Primary practice address
2104 Jolly Rd Suite 220 Okemos MI 48864-6043
Phone: (517) 975-1400
Fax: (517) 975-1405
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 5101010708 Michigan

Profile Details

NPI number 1417937723
LBN Legal business name Russell, Sandra K
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2006
Last updated Nov 29th, 2012 - about 12 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 1417937723 NPPES
Michigan Other 0700083 PHYSICIANS HEALTH PLAN
Michigan Other 160C311260 PHYSICIANS HEALTH PLAN
Michigan Other 160C311260 PHYSICIANS HEALTH PLAN
Michigan Other 1006244 PHYSICIANS HEALTH PLAN
Michigan Other E68082 PHYSICIANS HEALTH PLAN
Michigan MEDICAID 4460493 PHYSICIANS HEALTH PLAN
Michigan Other 160C311260 PHYSICIANS HEALTH PLAN
Michigan Other 1006244 PHYSICIANS HEALTH PLAN
Michigan Other 1652300205 PHYSICIANS HEALTH PLAN
Michigan Other 160C311260 PHYSICIANS HEALTH PLAN

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