Individual
RUSSELL JOHN WOLTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2525 CHICAGO AVE, MINNEAPOLIS, MN 55404-4518
(612) 813-6000
Mailing address
2525 CHICAGO AVE, MINNEAPOLIS, MN 55404-4518
(612) 813-6000
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
76651
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2017
Last updated
07/04/2024
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