Individual
RUSSELL DYLAN PURPURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 W MICHIGAN ST # CL630, INDIANAPOLIS, IN 46202-5209
(317) 278-2686
Mailing address
4458 MEDICAL DR STE 505, SAN ANTONIO, TX 78229-3748
(210) 690-7400
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
U3329
TX
390200000X
Student in an Organized Health Care Education/Training Program
11019509A
IN
Other
Enumeration date
06/16/2017
Last updated
05/26/2023
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