Individual
GRETEL L. RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 INDEPENDENCE DR, BIRMINGHAM, AL 35209-5662
(205) 870-1273
(205) 870-1276
Mailing address
PO BOX 59552, BIRMINGHAM, AL 35259-9552
(205) 870-1273
(205) 870-1276
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
28117
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009911070
—
AL
Enumeration date
02/02/2006
Last updated
05/01/2013
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