Organization
WILLIAM RUSSELL MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM RUSSELL M.D. (MEDICAL DOCTOR)
(301) 723-4380
Entity
Organization
Contact information
Practice address
600 VIRGINIA AVE STE 2, CUMBERLAND, MD 21502-4551
(301) 723-4380
(301) 723-4812
Mailing address
600 VIRGINIA AVE STE 2, PO BOX 1726, CUMBERLAND, MD 21502-4551
(301) 723-4380
(301) 723-4812
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
D0050636
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407824956
NPI #1
—
Enumeration date
02/03/2010
Last updated
02/03/2010
Update your record
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