Individual
ANDREW N. RUSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BOULEVARD, DETROIT, MI 48202
(313) 916-9106
(313) 916-1249
Mailing address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BOULEVARD, DETROIT, MI 48202
(313) 916-9106
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
5101014884
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130H264490
BLUE CROSS-BLUE CROSS
—
05
—
492844811
—
MI
01
—
AR014884
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
08/07/2006
Last updated
07/08/2007
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