Individual
DR. STEPHEN R RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3262 SALT CREEK CIR, LINCOLN, NE 68504-4761
(402) 465-5600
(402) 437-0852
Mailing address
8201 NORTHWOODS DR, LINCOLN, NE 68505-3092
(402) 465-5600
(402) 327-6074
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
20029
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025151600
—
NE
05
—
10026369300
—
NE
05
—
47079049100
—
NE
05
—
47079049112
—
NE
Enumeration date
12/29/2005
Last updated
03/06/2017
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