Organization
MASCOMA STREET INPATIENT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL HARRIS MD (PRESIDENT)
(954) 838-2371
Entity
Organization
Contact information
Practice address
10 ALICE PECK DAY DR, LEBANON, NH 03766-2900
(469) 401-2386
Mailing address
13737 NOEL RD STE 1600, DALLAS, TX 75240-1374
(954) 838-2371
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Enumeration date
07/25/2016
Last updated
09/10/2019
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