Individual
DR. ERIC MARC RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 E LANCASTER AVE, WYNNEWOOD, PA 19096-3450
(610) 645-2000
Mailing address
211 S ORANGE ST, APT. B, MEDIA, PA 19063-3110
(215) 459-0222
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OT011972
PA
207RR0500X
Rheumatology Physician
Primary
C2-0010067
DE
Other
Enumeration date
10/20/2009
Last updated
11/30/2020
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