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Individual

DR. RUSSELL DON MELDRUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5177 MCCARTY LN, LAFAYETTE, IN 47905-8764
(765) 448-8000
(765) 446-7088
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01052804A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01052804A
LICENSE
IN
01
01052804B
CSR
IN
05
200316320
IN
Enumeration date
05/13/2006
Last updated
03/07/2023
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