Organization
RUSSELL D. MELDRUM, M.D. PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL MELDRUM MD (OWNER/PHYSICIAN)
(317) 371-7230
Entity
Organization
Contact information
Practice address
855 W. SOUTHERN AVE., #1114, MESA, AZ 85210
(317) 371-7230
Mailing address
855 W. SOUTHERN AVE., #1114, MESA, AZ 85210
(317) 371-7230
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
51549
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51549
MEDICAL LICENSE NUMBER
AZ
Enumeration date
03/05/2018
Last updated
03/05/2018
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