Individual
RUSSELL EDWARD MCDOW JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
44055 RIVERSIDE PKWY, SUITE 102, LEESBURG, VA 20176-5179
(703) 858-3131
(703) 858-3130
Mailing address
PO BOX 17334, BALTIMORE, MD 21297-1334
(703) 443-6717
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101032827
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010092531
—
VA
05
—
010398398
—
VA
01
—
P00142427
RR MEDICARE
VA
Enumeration date
09/09/2005
Last updated
01/09/2010
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