Individual
DR. ROBERT LARON RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14585 DOVER DR, CARMEL, IN 46033-8561
(314) 703-5269
Mailing address
14585 DOVER DR, CARMEL, IN 46033-8561
(314) 703-5269
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2006034008
MO
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
01072922A
IN
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
01072922A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001161691
ANTHEM
—
05
—
201214540
—
IN
Enumeration date
06/26/2007
Last updated
03/06/2026
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