Individual
WILLIAM RUSSELL FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-7459
(574) 647-3658
Mailing address
328 N MICHIGAN ST, SUITE 200, SOUTH BEND, IN 46601-1244
(574) 647-1842
(574) 647-1825
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01041908A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3037390
—
MI
Enumeration date
11/01/2006
Last updated
07/08/2007
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