ALVARO H SERRANO RUSSI MD NPI 1306076039

NPI Information

NPI: 1306076039
Provider Name: ALVARO H SERRANO RUSSI, MD
Classification: Medical Genetics - 207SG0201X
Entity Type: Individual

Specialization: Clinical Genetics (M.D.)

PECOS Registration: Yes

Address:
325 N. STATE OF FRANKLIN ROAD
GROUND FL
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 439-7320
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Alvaro H Serrano Russi, MD is a clinical genetics (m.d.) medical genetics in Johnson City, TN with 22 years of experience. The provider is a clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. Alvaro H Serrano Russi, MD NPI is 1306076039. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

325 N. STATE OF FRANKLIN ROAD
GROUND FL
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 439-7320

The NPI 1306076039 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/15/2009 and was last updated on 1/25/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207SG0201X	Medical Genetics	Clinical Genetics (M.D.)	65362	TENNESSEE	Yes
2	208000000X	Pediatrics		65362	TENNESSEE	No
3	208D00000X	General Practice		MD436046	PENNSYLVANIA	No
4	207SG0201X	Medical Genetics	Clinical Genetics (M.D.)	C1422548	CALIFORNIA	No
5	208000000X	Pediatrics		39570	IOWA	No
6	207SG0201X	Medical Genetics	Clinical Genetics (M.D.)	MT194028	PENNSYLVANIA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Q074608	MEDICAID	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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