Russell, Mary Louise

Russell, Mary Louise is an individual health care provider with primary practice located at 1405 Shady Ave , Pittsburgh PA 15217-1350. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is her primary health care specialty. Russell, Mary Louise can be contacted via phone (412) 420-2270.

Contact Information

Primary practice address
1405 Shady Ave Pittsburgh PA 15217-1350
Phone: (412) 420-2270
Fax: (412) 420-4450
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD044119E Pennsylvania
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X MD044119E Pennsylvania
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 29378 West Virginia

Profile Details

NPI number 1184691222
LBN Legal business name Russell, Mary Louise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2006
Last updated Apr 12th, 2022 - about 4 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 1184691222 NPPES
Pennsylvania MEDICAID 1170159

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