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Individual

DR. RUSSELL C FRITZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
250 BON AIR RD, GREENBRAE, CA 94904-1702
(415) 884-3415
(415) 883-0877
Mailing address
PO BOX 6102, NOVATO, CA 94948-6102

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
21396
OK
2085R0202X
Diagnostic Radiology Physician
214699-1
NY
2085R0202X
Diagnostic Radiology Physician
31740
CO
2085R0202X
Diagnostic Radiology Physician
35-06-3882-F
OH
2085R0202X
Diagnostic Radiology Physician
36103737
IL
2085R0202X
Diagnostic Radiology Physician
4953
AK
2085R0202X
Diagnostic Radiology Physician
56
MT
2085R0202X
Diagnostic Radiology Physician
9663
NV
2085R0202X
Diagnostic Radiology Physician
Primary
G60870
CA
2085R0202X
Diagnostic Radiology Physician
J5764
TX
2085R0202X
Diagnostic Radiology Physician
MA71752
NJ
2085R0202X
Diagnostic Radiology Physician
MD00032517
WA
2085U0001X
Diagnostic Ultrasound Physician
28798
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G60870
OK
05
00G608700
CA
05
1317403
CO
01
300035761
RAILROAD MEDICARE
CA
01
300121784
RAILROAD MEDICARE
CA
05
8169633
WA
05
8563403
NJ
05
867666
AZ
Enumeration date
12/28/2005
Last updated
05/13/2020
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