Individual
RUSSELL AARON VAN MAELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
535 WELLINGTON WAY STE 330, LEXINGTON, KY 40503-1331
(859) 523-4375
Mailing address
535 WELLINGTON WAY STE 330, LEXINGTON, KY 40503-1331
(859) 523-4375
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04823
KY
390200000X
Student in an Organized Health Care Education/Training Program
5151012371
MI
Other
Enumeration date
06/08/2017
Last updated
07/21/2022
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