Massine, Russell Edmund

Massine, Russell Edmund is an individual health care provider with primary practice located at 1501 Ne Medical Center Dr , Bend OR 97701-6051. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Massine, Russell Edmund can be contacted via phone (541) 382-2811.

Contact Information

Primary practice address
1501 Ne Medical Center Dr Bend OR 97701-6051
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X MD25219 Oregon

Profile Details

NPI number 1447329032
LBN Legal business name Massine, Russell Edmund
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2006
Last updated Jan 29th, 2021 - about 5 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 1447329032 NPPES
Oregon Other 00834462 MEDICARE RAILROAD
Oregon MEDICAID 274087 MEDICARE RAILROAD

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