Individual
RUSSELL G REMALIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
260 ELM ST, CUMMING, GA 30040-2467
(770) 887-1668
(770) 781-9937
Mailing address
260 ELM ST, CUMMING, GA 30040-2467
(770) 887-1668
(770) 781-9937
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1305
ME
207Q00000X
Family Medicine Physician
74998
GA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
74998
GA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
OS9988
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130110000
—
ME
05
—
130110099
—
ME
05
—
280165500
—
FL
Enumeration date
10/05/2006
Last updated
08/03/2016
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