Individual
DR. RUSSELL L MAIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 GREENWICH PL, SHELTON, CT 06484-4618
(866) 436-9631
(203) 929-2344
Mailing address
14275 MIDWAY RD, SUITE 400, ADDISON, TX 75001-3614
(866) 436-9631
(610) 271-4245
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
036583
CT
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036583
CT
Other
Enumeration date
01/13/2006
Last updated
05/29/2015
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