Individual
MARK DEAN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2 HERITAGE OAK LN, BATTLE CREEK, MI 49015-4250
(269) 979-6360
(269) 979-6380
Mailing address
2 HERITAGE OAK LN, BATTLE CREEK, MI 49015-4250
(269) 979-6360
(269) 979-6380
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MR008352
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1726627
—
MI
Enumeration date
09/27/2005
Last updated
11/27/2023
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