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Individual
DR. ANTHONY HENRYK RUSSELL
Active
Individual
DR. ANTHONY HENRYK RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
40275
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040275
TUFTS HEALTH PLAN
MA
05
—
2003937
—
MA
01
—
J25906
BCBS MA
MA
Enumeration date
11/17/2005
Last updated
12/04/2012
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