Individual
BRAD C RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
520 UPPER CHESAPEAKE DR, SUITE 306, BEL AIR, MD 21014-4339
(410) 879-2006
(410) 879-0248
Mailing address
520 UPPER CHESAPEAKE DR, SUITE 306, BEL AIR, MD 21014-4339
(410) 879-2006
(410) 879-0248
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C0003144
MD
Other
Enumeration date
06/12/2006
Last updated
06/05/2014
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