Individual
DR. ANTHONY HENRYK RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 BLOSSOM ST, COX LL, BOSTON, MA 02114-2606
(617) 726-8650
(617) 726-3603
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 726-7559
(617) 726-3603
Taxonomy
Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
40275
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040275
TUFTS HEALTH PLAN
MA
05
—
2003937
—
MA
01
—
J25906
BCBS MA
MA
Enumeration date
11/17/2005
Last updated
12/04/2012
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