Individual
DR. DEMAURA H RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
702 N MAIN ST, ROXBORO, NC 27573-4755
(336) 599-9271
(336) 599-0347
Mailing address
702 N MAIN ST, ROXBORO, NC 27573-4755
(336) 599-9271
(336) 599-0347
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2013-01723
NC
207R00000X
Internal Medicine Physician
2013-01723
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114218492
—
NC
Enumeration date
04/21/2011
Last updated
02/02/2021
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