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Individual
RUSSELL DURING
Active
Individual
RUSSELL DURING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005611
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005611
STATE LICENSE NUMBER
GA
Enumeration date
08/12/2009
Last updated
08/04/2026
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