Individual
DR. BRIAN W. RUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5300 FAR HILLS AVE, DAYTON, OH 45429-2347
(937) 312-3830
(937) 433-9612
Mailing address
5300 FAR HILLS AVE, DAYTON, OH 45429-2347
(937) 312-3830
(937) 433-9612
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
58606
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000731123
ANTHEM BC/BS
OH
01
—
3380966
UNITED HEALTHCARE
OH
01
—
759842
AETNA
OH
01
—
7766410
CIGNA
OH
01
—
P00977283
RAILROAD MEDICARE
—
Enumeration date
08/09/2006
Last updated
08/03/2016
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