Individual
STEPHEN WILBON RUSSELL
Active
Individual
STEPHEN WILBON RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28087
AL
207R00000X
Internal Medicine Physician
35-080853
OH
208000000X
Pediatrics Physician
35-080853
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009943077
—
AL
01
—
051110649
BLUE CROSS
AL
01
—
051114567
BLUE CROSS
AL
01
—
051541057
BLUE CROSS
AL
05
—
108956
—
AL
05
—
116248
—
AL
05
—
125496
—
AL
05
—
127053
—
AL
05
—
200469750
—
IN
05
—
2467736
—
OH
01
—
51103180
BLUE CROSS
AL
05
—
64078314
—
KY
01
—
P00653613
RAILROAD MEDICARE
AL
Enumeration date
05/03/2006
Last updated
06/29/2023
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