Organization
DR RUSSELL O SCHUB PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL O. SCHUB D.O. (PRESIDENT)
(410) 730-1000
Entity
Organization
Contact information
Practice address
8875 CENTRE PARK DR, SUITE D, COLUMBIA, MD 21045-2382
(410) 730-1000
(410) 730-8615
Mailing address
8875 CENTRE PARK DR, SUITE D, COLUMBIA, MD 21045-2382
(410) 730-1000
(410) 730-8615
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
526471500
—
MD
01
—
8338RU
BLUE SHIELD
MD
01
—
C428
BLUE SHIELD
DC
Enumeration date
08/27/2007
Last updated
01/08/2009
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