Individual
DR. RUSSELL W PELLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10110 DONALD POWERS DR, SUITE 202, MUNSTER, IN 46321
(219) 922-0222
(219) 922-8899
Mailing address
10110 DONALD POWERS DR, SUITE 202, MUNSTER, IN 46321-2915
(219) 922-0222
(219) 922-8899
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01029020A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100200800
—
IN
Enumeration date
05/05/2006
Last updated
08/17/2012
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