| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SARAH FULHAM RUSSELL | 1417241415 | 2024-11-09 |
Sarah Bj Fulham [F] graduated in 2011 and primarily specializes in Internal Medicine.
Sarah Fulham Russell is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1417241415. Registration indicates Sarah Fulham Russell is a provider of access to adult/geriatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, Internal Medicine Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Internal Medicine) (Internal Medicine, ) (Allopathic & Osteopathic Physicians, Internal Medicine) (Primary Care/Family Planning/APRN/PA, ) (Internal Medicine, Allopathic & Osteopathic Physicians) Access to Adult/Geriatric Primary Care Providers (Allopathic & Osteopathic Physicians, Internal Medicine) Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Internal Medicine) (Internal Medicine, ) (Allopathic & Osteopathic Physicians, Internal Medicine) (Primary Care/Family Planning/APRN/PA, ) (Internal Medicine, Allopathic & Osteopathic Physicians)
| PECOS ID | 5698097889 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Sarah Fulham Russell M.D. |
| Practice Office Address | 57 PROSPECT ST NANTUCKET, MA US |
| Practice Office Telephone | 5088258100 |
| Mailing Address | 57 PROSPECT ST NANTUCKET, MA 025542799 US |
| Business Telephone | 5088258100 |
| FHIR URL [CCD] | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other FHIR API |
| Direct Messaging Address [[email protected]] | [email protected] | Direct |
| Code | Practice | License No State |
|---|---|---|
| 207R00000X | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Internal MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Internal Medicine Internal Medicine Allopathic & Osteopathic Physicians Internal Medicine Primary Care/Family Planning/APRN/PA Internal Medicine Allopathic & Osteopathic Physicians | 65857-20
WI |
| 207R00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Internal MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Internal Medicine Internal Medicine Allopathic & Osteopathic Physicians Internal Medicine Primary Care/Family Planning/APRN/PA Internal Medicine Allopathic & Osteopathic Physicians | 1021381
MA |
| 1417241415 | MEDICAID | WI |