Russell, William A
Russell, William A is an individual health care provider with primary practice located at 1905 Glen Meade Rd , Wilmington NC 28403-6024. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Russell, William A can be contacted via phone (910) 763-6251.Contact Information
Primary practice address
1905 Glen Meade Rd
Wilmington NC 28403-6024
Phone: (910) 763-6251
Fax: (910) 763-7408
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 33464 | North Carolina |
Profile Details
| NPI number | 1689674954 |
|---|---|
| LBN Legal business name | Russell, William A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 28th, 2005 |
| Last updated | Jan 10th, 2014 - about 10 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 | 1689674954 | NPPES |
| North Carolina | MEDICAID | 8974046 |
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