Russell, Sudha A

Russell, Sudha A is an individual health care provider with primary practice located at 1835 N Broadway , Santa Maria CA 93454-1404. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Russell, Sudha A can be contacted via phone (805) 345-3701.

Contact Information

Primary practice address
1835 N Broadway Santa Maria CA 93454-1404
Phone: (805) 345-3701
Fax: (805) 345-3745
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 207PP0204X G54900 California
Allopathic & Osteopathic Physicians / Pediatrics 208000000X G54900 California

Profile Details

NPI number 1528037892
LBN Legal business name Russell, Sudha A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2006
Last updated Aug 12th, 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 1528037892 NPPES
Florida Other 10100 BCBS PROVIDER #
Florida MEDICAID 057297799 BCBS PROVIDER #

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