Nord, Russell Marc

Nord, Russell Marc is an individual health care provider with primary practice located at 38690 Stivers St Suite A, Fremont CA 94536-5279. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Nord, Russell Marc can be contacted via phone (510) 248-1040.

Contact Information

Primary practice address
38690 Stivers St Suite A Fremont CA 94536-5279
Phone: (510) 248-1040
Fax: (510) 797-7426
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X A103896 California

Profile Details

NPI number 1245436542
LBN Legal business name Nord, Russell Marc
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2007
Last updated Apr 18th, 2019 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245436542 NPPES
California MEDICAID 51941

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