Individual
DR. RAYMOND S RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4000 MIAMISBURG CENTERVILLE RD, SUITE 405, MIAMISBURG, OH 45342-7615
(937) 560-2011
(937) 560-2012
Mailing address
4000 MIAMISBURG CENTERVILLE RD STE 207, MIAMISBURG, OH 45342-3674
(937) 560-2011
(937) 560-2012
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
35073039
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2169380
—
OH
Enumeration date
05/26/2006
Last updated
11/24/2020
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