Russo, Patrick J
Russo, Patrick J is an individual health care provider with primary practice located at 2555 Court Dr Suite 300, Gastonia NC 28054-2134. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Nuclear Cardiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Russo, Patrick J can be contacted via phone (704) 868-3256.Contact Information
Primary practice address
2555 Court Dr Suite 300
Gastonia NC 28054-2134
Phone: (704) 868-3256
Fax: (704) 868-5870
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 26794 | South Carolina |
| Allopathic & Osteopathic Physicians / Nuclear Cardiology | 207UN0901X | 200301049 | North Carolina |
| Allopathic & Osteopathic Physicians / Nuclear Cardiology | 207UN0901X | 26794 | South Carolina |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 200301049 | North Carolina |
Profile Details
| NPI number | 1861490195 |
|---|---|
| LBN Legal business name | Russo, Patrick J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 11th, 2005 |
| Last updated | Jun 8th, 2017 - about 7 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 | 1861490195 | NPPES |
| North Carolina | MEDICAID | 891345R | |
| North Carolina | MEDICAID | N01046 |
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