Individual
EDWARD RUSSEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1800 LINGLESTOWN RD, SUITE 201, HARRISBURG, PA 17110-3347
(717) 233-3630
(717) 233-3439
Mailing address
1800 LINGLESTOWN RD, SUITE 201, HARRISBURG, PA 17110-3347
(717) 233-3630
(717) 233-3439
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD035844L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
462629
PROVIDER ID
PA
Enumeration date
01/18/2007
Last updated
05/03/2017
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