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Individual

RUSSELL ALAN KESMAN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-4393
Mailing address
6301 ALMEDA RD APT 134, HOUSTON, TX 77021-1056
(708) 334-7248

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD460819
PA
208000000X
Pediatrics Physician
R1560
TX
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MT212422
PA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/26/2014
Last updated
07/21/2022
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