Provider Demographics
NPI:1598874489
Name:RUSS, DONALD BARNARD (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:BARNARD
Last Name:RUSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:327 1ST AVE NW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-6122
Mailing Address - Country:US
Mailing Address - Phone:828-695-5900
Mailing Address - Fax:828-695-4256
Practice Address - Street 1:350 E PARKER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-5155
Practice Address - Country:US
Practice Address - Phone:828-624-1900
Practice Address - Fax:828-695-4256
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC209572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC494265000OtherMAGELLAN BEHAVIORAL HEALTH
NC183470OtherMEDCOST
NCREFER TO UBHOtherUNITED BEHAVIORAL HEALTH
NCREFER TO EVERCAREOtherEVERCARE
NC2302593OtherCIGNA BEHAVIORAL HEALTH
NC5900196Medicaid
NC74033OtherBCBS
NC5900196Medicaid