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Individual

TODD E RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2109 HUGHES DR, SUITE 450, TOLEDO, OH 43606-3856
(419) 291-2003
(419) 479-6977
Mailing address
2109 HUGHES DR, SUITE 450, TOLEDO, OH 43606-3856
(419) 291-2003
(419) 479-6977

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
35074626
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000493404
ANTHEM
OH
01
03444
PARAMOUNT
OH
01
10221
HEALTH PLAN OF MI
OH
01
21-01841
UHC
OH
05
2215678
OH
05
4957870
MI
01
5773778
AETNA
OH
01
P00366278
RRMC
OH
Enumeration date
07/19/2005
Last updated
11/03/2023
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