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Individual

DR. RUSSELL L LIVINGSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
202 W PLAIN ST, WAYLAND, MA 01778-4346
(617) 943-2330
(810) 267-9375
Mailing address
202 W PLAIN ST, WAYLAND, MA 01778-4346
(617) 943-2330
(810) 267-9375

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
57414
MA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
57414
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3153592
MA
01
J16493
BCBS HMO PPO FEDERAL
MA
Enumeration date
07/12/2006
Last updated
01/27/2025
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