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Individual
DR. SARAH MARIE RUSSELL
Active
Individual
DR. SARAH MARIE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
11018452A
IN
207R00000X
Internal Medicine Physician
Primary
4301117303
MI
207RG0100X
Gastroenterology Physician
4301117303
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301117303
LICENSE NUMBER
MI
Enumeration date
06/16/2015
Last updated
04/22/2022
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