Provider Demographics
NPI:1871593251
Name:RUSSELL, DAVID NORMAN (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:NORMAN
Last Name:RUSSELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:310 MOCKSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-3328
Mailing Address - Country:US
Mailing Address - Phone:704-762-9630
Mailing Address - Fax:919-576-1372
Practice Address - Street 1:310 MOCKSVILLE AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-3328
Practice Address - Country:US
Practice Address - Phone:704-762-9630
Practice Address - Fax:919-576-1372
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25525208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine