Deborah L Russell MD PLLC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

Legal business name

DEBORAH L RUSSELL MD PLLC

Practice address

4177 Fashion Square Blvd.
Suite # 1
Saginaw, MI 48603-5216

Phone

(989) 791-9100

Fax

(989) 791-6746

NPI assigned

Mar 20, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Deborah Lee Russell, MD

Title

Owner

Phone

(989) 791-9100

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Deborah L Russell MD and Paul A Meyer MD PC Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1962527655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4177 FASHION SQUARE BLVD.",
            "address_2": "SUITE # 1",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486035216",
            "telephone_number": "989-791-9100",
            "fax_number": "989-791-6746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4177 FASHION SQUARE BLVD.",
            "address_2": "SUITE # 1",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486035216",
            "telephone_number": "989-791-9100",
            "fax_number": "989-791-6746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORAH L RUSSELL MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-791-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301053500",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704246844",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "700G310050",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3170069",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deborah L Russell MD and Paul A Meyer MD PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Deborah L Russell MD and Paul A Meyer MD PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kathryn Anne Dean, LMSW
• Meagan Johanna Dean, PHARMD
• Olivia Madison Dean, RN
• Christa Deban
• Rachel Deboer
• Jesus Antonio Decena
• Jack Decker, CRNA
• Joseph Decker
• Helen Judith Decorte, N.P.
• Virginia Dedicatoria, M.D.

• Gynecology Physician in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.