1427187152 NPI number — DR. RUSSELL DAVID MACDONALD MD MPH

Table of content: DR. RUSSELL DAVID MACDONALD MD MPH (NPI 1427187152)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427187152 NPI number — DR. RUSSELL DAVID MACDONALD MD MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MACDONALD
Provider First Name:
RUSSELL
Provider Middle Name:
DAVID
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD MPH
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427187152
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14375 8TH CONCESSION
Provider Second Line Business Mailing Address:
RR #1
Provider Business Mailing Address City Name:
SCHOMBERG
Provider Business Mailing Address State Name:
ONTARIO
Provider Business Mailing Address Postal Code:
L0G1T0
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
905-859-1551
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ORNGE TRANSPORT MEDICINE
Provider Second Line Business Practice Location Address:
20 CARLSON COURT, SUITE 400
Provider Business Practice Location Address City Name:
TORONTO
Provider Business Practice Location Address State Name:
ONTARIO
Provider Business Practice Location Address Postal Code:
M9W 7K6
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
647-428-2034
Provider Business Practice Location Address Fax Number:
647-428-2006
Provider Enumeration Date:
03/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207PE0004X , with the licence number:  154068 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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