Demaura H Russell (NPI# 1114218492, PAC ID# 1456585066) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
Nation Provider ID (NPI) | 1114218492 |
PAC ID by PECOS | 1456585066 |
Professional Enrollment ID | I20131015001779 |
Full Name | Demaura H Russell |
Organization Legal Name | HOPE REGIONAL MEDICAL CLINIC |
Address |
546 W Ridgeway St Warrenton NC 27589-1716 |
Phone Number | 2522421010 |
Gender | F |
Graduation Year | 2010 |
Primary Specialty | FAMILY MEDICINE |
Group Practice PAC ID | 2961735873 |
Number of Group Practice Members | 2 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
340159 | PERSON MEMORIAL HOSPITAL |
340132 | MARIA PARHAM MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
315 Franklin Plz, Louisburg, NC 27549-2765 | 9194964976 | IMPACT HEALTHCARE, P.A. |
546 W Ridgeway St, Warrenton, NC 27589-1716 | 2522421010 | HOPE REGIONAL MEDICAL CLINIC |
Organization Legal Name | HOPE REGIONAL MEDICAL CLINIC |
Physicians | 2 |
Name | Specialty | Organization | Address |
---|---|---|---|
Latisha Darsha Patterson | Physician Assistant | Hope Regional Medical Clinic | 546 W Ridgeway St, Warrenton, NC 27589-1716 |
Street Address |
546 W RIDGEWAY ST |
City | WARRENTON |
State | NC |
Zip | 27589-1716 |
Name | Specialty | Organization | Address |
---|---|---|---|
Latisha Darsha Patterson | Physician Assistant | Hope Regional Medical Clinic | 546 W Ridgeway St, Warrenton, NC 27589-1716 |
Name | Specialty | Organization | Address |
---|---|---|---|
Yvette R Douglas-lewis | Family Practice | Warrenton Family Practice, Pllc | 163 Christmas Rd, Warrenton, NC 27589-8723 |
City | WARRENTON |
Zip Code | 27589 |
Specialty | FAMILY MEDICINE |
City + Specialty | WARRENTON + FAMILY MEDICINE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.