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Individual
ERIC RUSSELL
Active
Individual
ERIC RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MTL-2018-009
GU
208000000X
Pediatrics Physician
P6514
TX
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
P6514
TX
Other
Enumeration date
07/06/2010
Last updated
06/06/2024
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