Individual
DR. W RANDALL RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 E LANCASTER AVE, SUITE 151 LANKENAU MOB EAST, WYNNEWOOD, PA 19096-3450
(484) 476-6492
(484) 476-8147
Mailing address
100 E LANCASTER AVE, SUITE 151 LANKENAU MOB EAST, WYNNEWOOD, PA 19096-3450
(484) 476-6492
(484) 476-8147
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD032388E
PA
Other
Enumeration date
07/01/2005
Last updated
03/27/2015
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