Organization
RUSSELL JAMES GROUP, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL J HIBLER PH.D (OWNER)
(410) 721-2133
Entity
Organization
Contact information
Practice address
857 PARK AVE, BALTIMORE, MD 21201-4800
(410) 244-0227
(866) 695-6454
Mailing address
1589 ETON WAY, CROFTON, MD 21114-1524
(410) 721-2133
(866) 695-6454
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
01803
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700842903
INDIVIDUAL NPI
—
Enumeration date
03/15/2013
Last updated
02/12/2015
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