Individual
TROY S RUSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 N 10TH ST, BISMARCK, ND 58501-4516
(701) 530-7500
(701) 530-7484
Mailing address
310 N 10TH ST, BISMARCK, ND 58501-4516
(701) 530-7500
(701) 530-7484
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
11486
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100498200
—
MN
05
—
35112600
—
WI
05
—
ENROLLED
—
IA
Enumeration date
08/13/2007
Last updated
07/16/2010
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