Individual
DR. CORI ELIZABETH RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202
(313) 916-2600
Mailing address
915 BERKSHIRE RD, GROSSE POINTE PARK, MI 48230-1821
(612) 518-8080
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
251525
MA
207RC0000X
Cardiovascular Disease Physician
Primary
4301114487
MI
Other
Enumeration date
06/21/2012
Last updated
08/29/2018
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