Individual
STEPHEN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
80 JESSE HILL JR DR SE, ATLANTA, GA 30303-3031
(404) 616-1000
Mailing address
615 MICHAEL ST NE STE 205, ATLANTA, GA 30322-2560
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
272394
MA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
95602
GA
207RP1001X
Pulmonary Disease Physician
Primary
95602
GA
390200000X
Student in an Organized Health Care Education/Training Program
272394
MA
Other
Enumeration date
03/21/2017
Last updated
05/08/2024
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