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Individual

RUSSELL W HARTUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
75 BEEKMAN ST, PLATTSBURGH, NY 12901-1438
(518) 561-2000
(518) 561-0881
Mailing address
PO BOX 2868, PLATTSBURGH, NY 12901-0259
(518) 562-7900
(518) 562-7933

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
198204
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000490094001
BS OF NENY
NY
05
02177411
NY
01
0926V7
EMPIRE BC BS
NY
01
114406
VALUE OPTIONS
NY
01
90031
MVP
NY
Enumeration date
11/28/2006
Last updated
08/17/2007
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