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Individual

THOMAS EDWARD RUSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
26461
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
550705700
MN
Enumeration date
06/30/2006
Last updated
05/09/2011
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