MEDICARE: DR. DAVID NORMAN RUSSELL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	25525	NC
2	207Q00000X	Family Medicine Physician	25525	NC

General Provider Information

NPI Number	:	1871593251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID NORMAN RUSSELL M.D.

Provider Business Mailing Address
First Line	:	310 MOCKSVILLE AVE
Second Line	:
City	:	SALISBURY
State	:	NC
Zip	:	28144-3328
Country	:	US
Telephone Number	:	704-762-9630
Fax Number	:	919-576-1372

Provider Business Practice Location Address
First Line	:	310 MOCKSVILLE AVE
Second Line	:
City	:	SALISBURY
State	:	NC
Zip	:	28144-3328
Country	:	US
Telephone Number	:	704-762-9630
Fax Number	:	919-576-1372

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	10/15/2025

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