Individual
RUSSELL T MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
35 MILES ST, DAMARISCOTTA, ME 04543-4047
(207) 563-4329
(207) 563-4884
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266
(207) 482-7800
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD10261
ME
Other
Enumeration date
09/19/2005
Last updated
11/20/2015
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