MARK RUSSO (NPI# 1588745392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588745392 |
| Entity Type | Individual |
| Full Name | MARK RUSSO |
| Credential | MD |
| Practice Address |
301 E Wendover Ave Ste 412 Greensboro NC 27401-1230 |
| Mailing Address |
Po Box 19305 Charlotte NC 28219-9305 |
| Practice Telephone | 3362350866 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-09-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
9500209 | NC | Allopathic & Osteopathic Physicians |
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
40291 | SC | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10502 Park Rd, Ste 150, Charlotte, NC 282108479 | 7046670520 | |
| 11 Gateway Corners Park, Columbia, SC 292038902 | 7043556569 | |
| 1350 S Kings Dr, Charlotte, NC 282072134 | 7044461255 | |
| 10502 Park Rd, Ste 110, Charlotte, NC 282108479 | 7046671550 | |
| 301 E Wendover Ave, Ste 412, Greensboro, NC 274011230 | 3362350866 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669784419 | Mark Brennan Russo | Home Health | 751 Hebron Pkwy Ste 160, Lewisville, TX 75057-5120 | 2010-07-09 |
| 1942448659 | Mark Vincent Russo | Chiropractor | 310 Mountain Ave, North Caldwell, NJ 07006-4013 | 2009-02-03 |
| 1619357282 | Mark Russo | Surgery | 3800 Reservoir Rd Nw, Dept of Otolaryngology, Washington, DC 20007-2113 | 2015-06-09 |
| 1083024327 | Mark Russo | Specialist/Technologist | 5823 Widewaters Pkwy, East Syracuse, NY 13057-3081 | 2014-05-07 |
| 1386976827 | Mark Russo | Pharmacist | 437 Electronics Pkwy, Liverpool, NY 13088-6001 | 2010-02-09 |
| 1326289786 | Mark Joseph Russo | Specialist | 201 Lyons Avenue, Newark Beth Israel Medical Center, Newark, NJ 07112 | 2009-03-16 |
| 1316934326 | Mark Steven Russo | Internal Medicine | 878 109th Ave N, Naples, FL 34108-1821 | 2005-10-04 |
| Street Address |
301 E WENDOVER AVE STE 412 |
| City | GREENSBORO |
| State | NC |
| Zip Code | 27401-1230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043214687 | Bryan K Bartle | Surgery | 301 E Wendover Ave, Suite 411, Greensboro, NC 27401-1230 | 2005-06-10 |
| 1902364029 | Alexis Scotece | Dietitian, Registered | 301 E Wendover Ave, Greensboro, NC 27401 | 2019-03-07 |
| 1265918171 | Rosalynne Faith Lopez | Health Educator | 301 E Wendover Ave, Greensboro, NC 27401-1230 | 2018-07-13 |
| 1689185068 | Cassie Lynn Kuppelweiser | Pharmacist | 301 E Wendover Ave, Greensboro, NC 27401-1230 | 2017-10-12 |
| 1780119636 | Minh Pham | Pharmacist | 301 E Wendover Ave, Suite 111, Greensboro, NC 27401-1230 | 2017-04-28 |
| 1457897175 | Jennifer Lauren Rafeek | Nurse Practitioner | 301 E Wendover Ave, Suite 400, Greensboro, NC 27401-1230 | 2017-01-19 |
| 1730625518 | Cone Center for Children | Clinic/Center | 301 E Wendover Ave, Suite 400, Greensboro, NC 27401-1230 | 2017-01-17 |
| 1942666953 | Central Carolina Health Network | Voluntary or Charitable | 301 E Wendover Ave, Ste 113, Greensboro, NC 27401-1230 | 2016-01-06 |
| 1285018366 | Michelle Elizabeth Stoisits | Social Worker | 301 E Wendover Ave, 400, Greensboro, NC 27401-1230 | 2015-07-17 |
| 1710396841 | Dawn Drazek | Nurse Practitioner | 301 E Wendover Ave, Ste 412, Greensboro, NC 27401-1230 | 2014-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779655 | Warfair Counseling, Consulting, & Supervision, Pllc | Counselor | 301 South Elm Street, Suite 801, Greensboro, NC 27401 | 2020-10-28 |
| 1225636848 | Alma Lucero Diaz | Registered Nurse | 1121 North Church St, Greensboro, NC 27401 | 2020-10-15 |
| 1447865217 | Rebecca Levy | Marriage & Family Therapist | Cone Health Family Medicine 1125 N Church Street, Greensboro, NC 27401 | 2020-09-09 |
| 1346854304 | Rayna's Home Care, LLC | Registered Nurse | 823 North Elm Street, Greensboro, NC 27401 | 2020-09-06 |
| 1316574718 | Garrett Green | Physician Assistant | 1121 N Church St., Greensboro, NC 27401 | 2020-03-25 |
| 1629635685 | Lauren Robinson Byrd | Anesthesiology | 1200 North Church St, Greensboro, NC 27401 | 2019-05-24 |
| 1285103069 | Shannon Marie Childs Meyerhoff | Occupational Therapist | Guilford County Schools Ec, 134 Franklin Blvd, Greensboro, NC 27401 | 2018-11-21 |
| 1194293241 | Ashley Marie Smith | Nurse Practitioner | 1200 North Elm St, Greensboro, NC 27401 | 2018-11-07 |
| 1285117762 | Anastazia Juszczak Gray | Speech-Language Pathologist | 1131 N. Church St, Greensboro, NC 27401 | 2018-09-11 |
| 1619474012 | Jamie Hannah Rose Aldridge | Psychiatry & Neurology | 1121 N Church Street, Greensboro, NC 27401 | 2018-04-11 |
| Find all providers in zip 27401 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821394370 | Parag A Brahmbhatt | Internal Medicine | 1002 N Church St Ste 201, Greensboro, NC 27401-1448 | 2011-02-01 |
| 1881701928 | Jyothi Nat Mann | Internal Medicine | 1593 Yanceyville St Bldg A, Suite 100, Greensboro, NC 27405-6948 | 2006-08-24 |
| 1164435103 | Patrick Dean-tzo Hung | Internal Medicine | 1593 Yanceyville St., Suite 100, Greensboro, NC 27405-6948 | 2006-08-14 |
| 1497209613 | Digestive Health Specialists, Pa | Internal Medicine | 6316 Old Oak Ridge Rd, Greensboro, NC 27410-9939 | 2016-08-04 |
| 1316303076 | Bethany Medical Center | Internal Medicine | 3402 Battleground Ave, Greensboro, NC 27410-2404 | 2016-01-12 |
| 1932534914 | Carolinas Medical Center | Internal Medicine | 301 E Wendover Ave, Ste 412, Greensboro, NC 27401-1230 | 2013-09-09 |
| 1417110057 | Kavitha Veena Nandigam | Internal Medicine | 520 N Elam Ave, Lebauer Gastroenterology, Greensboro, NC 27403-1127 | 2008-07-03 |
| 1457423907 | Eagle Physicians and Associates Pa | Internal Medicine | 301 E Wendover Ave, Suite 200, Greensboro, NC 27401-1230 | 2006-11-13 |
| 1386713238 | James C Weissman | Internal Medicine | 301 E Wendover Ave, Suite 200, Greensboro, NC 27401-1230 | 2006-11-07 |
| 1174692248 | Martin K Johnson IIi | Internal Medicine | 301 E Wendover Ave, Suite 200, Greensboro, NC 27401-1230 | 2006-11-06 |
| Find all providers in GREENSBORO | ||||
| City | GREENSBORO |
| Zip Code | 27401 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.