Individual
JENNIFER D RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
53 MARION RD, WAREHAM, MA 02571-1406
(508) 295-8622
(508) 295-5386
Mailing address
53 MARION RD, SUITE ONE, WAREHAM, MA 02571-1406
(508) 295-8622
(508) 295-5386
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
160688
MA
Other
Enumeration date
05/02/2006
Last updated
12/06/2011
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