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Individual
DR. PETER CRIAG RUSS
Active
Individual
DR. PETER CRIAG RUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
028399
CT
207Q00000X
Family Medicine Physician
Primary
2007-00384
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001283994
—
CT
05
—
5910498
—
NC
01
—
P00716054
MEDICARE RAILROAD
—
Enumeration date
07/11/2005
Last updated
12/07/2023
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