Individual
JOSE R. RUSSE RUSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 SAINT PAUL ST, BALTIMORE, MD 21202-2102
(410) 332-9000
Mailing address
2201 HEMPSTEAD TPKE, EAST MEADOW, NY 11554-1859
(516) 572-5100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D0095718
MD
207RI0008X
Hepatology Physician
Primary
D0095718
MD
208M00000X
Hospitalist Physician
D0095718
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D0095718
PHYSICIAN LICENSE NUMBER
MD
Enumeration date
08/05/2019
Last updated
09/21/2023
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