Struble, Russell J

Struble, Russell J is an sole proprietor health care provider with primary practice located at 200 S Wenona St Suite 100, Bay City MI 48706-8820. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Struble, Russell J can be contacted via phone (989) 892-6587.

Contact Information

Primary practice address
200 S Wenona St Suite 100 Bay City MI 48706-8820
Fax: (989) 892-3140
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X RS068547 Michigan

Profile Details

NPI number 1154355477
LBN Legal business name Struble, Russell J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 10th, 2006
Last updated Oct 8th, 2011 - about 13 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 1154355477 NPPES
Michigan Other RS068547 BCR LICENSE NUMBER
Michigan MEDICAID 4115114 BCR LICENSE NUMBER

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