Individual
MR. RUSSELL Q QUEEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
550 STANTON CHRISTIANA RD, SUITE 303, NEWARK, DE 19713-2198
(303) 633-9900
(302) 633-9905
Mailing address
550 STANTON CHRISTIANA RD, SUITE 303, NEWARK, DE 19713-2198
(302) 633-9900
(302) 633-9905
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C50000411
DE
Other
Enumeration date
05/20/2006
Last updated
07/08/2007
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