Organization
BEHAVIOR AND SLEEP MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND GRANT RUSSELL (M.D.)
(937) 434-4611
Entity
Organization
Contact information
Practice address
4000 MIAMISBURG CENTERVILLE ROAD, SLEEP LAB, MIAMISBURG, OH 45342
(937) 885-7556
(937) 384-4826
Mailing address
880 VINTAGE LAKE COURT, DAYTON, OH 45458-4088
(937) 885-7556
(937) 384-4826
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
35-036352
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0521537
—
OH
Enumeration date
07/16/2009
Last updated
07/16/2009
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