# DR. RUSSELL WELDON MAYES

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1316162704
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | 5101015814 | MI | Yes |

## Other

- **Enumeration date:** 04/13/2007
- **Last updated:** 12/29/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 808041500 | — | ID |
| 01 | — | P00654616 | MCRR | ID |