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Individual

JACQUELINE M RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
37 PALMER ST STE 3, CALAIS, ME 04619-1341
(207) 454-8195
Mailing address
210 HOLMES RD, SCARBOROUGH, ME 04074-8410
(207) 995-0732

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO3305
ME

Other

Enumeration date
04/20/2019
Last updated
09/08/2023
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