Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 2010-01505 | NC |
N | 2080P0208X | Pediatric Infectious Diseases | 2010-01505 | NC |
NPI | 1447569223 |
---|---|
Provider Name | Dr. Marsha Yolanda Russell |
First Address | Morrisville, NC 27560-8442 |
Second Address | Dunn, NC 28334-5510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2010 |
Last Update Date | 10/08/2021 |