Individual
CHRISTOPHER M RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1812 N MILLS AVE, ORLANDO, FL 32803-1834
(407) 897-3499
(407) 896-9454
Mailing address
1812 N MILLS AVE, ORLANDO, FL 32803-1834
(407) 897-3499
(407) 896-9454
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME141118
FL
390200000X
Student in an Organized Health Care Education/Training Program
4301106752
MI
Other
Enumeration date
05/19/2015
Last updated
07/29/2020
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