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Individual
DR. BRYAN C RUSSELL
Active
Individual
DR. BRYAN C RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
MC04977
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0741915000
AMERIHEALTH
NJ
01
—
1874679
UNITED HEALTHCARE
NJ
01
—
5257680
AETNA
NJ
01
—
5716020
MULTIPLAN
NJ
01
—
662068
ACN
NJ
01
—
P2039337
OXFORD
NJ
Enumeration date
06/15/2005
Last updated
12/28/2023
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