Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
SUDHA A RUSSELL
Active
Individual
SUDHA A RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
G54900
CA
208000000X
Pediatrics Physician
Primary
G54900
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057297799
—
FL
01
—
10100
BCBS PROVIDER #
FL
Enumeration date
03/17/2006
Last updated
08/12/2021
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