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Individual

DR. DEBORAH LEE RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4177 FASHION SQUARE BLVD, SUITE 1, SAGINAW, MI 48603-5216
(989) 791-9100
(989) 791-6746
Mailing address
4177 FASHION SQUARE BLVD, SUITE 1, SAGINAW, MI 48603-5216
(989) 791-9100
(989) 791-6746

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
4301053500
MI
207VG0400X
Gynecology Physician
Primary
4301053500
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3170069
MI
Enumeration date
07/31/2006
Last updated
04/01/2021
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