Organization
COLDWATER CROSSING INTERNAL MEDICINE, PLLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY RUSSELL D.O. (OWNER)
(517) 278-8000
Entity
Organization
Contact information
Practice address
327 W CHICAGO ST, COLDWATER, MI 49036-2805
(517) 278-8000
(517) 278-8007
Mailing address
327 W CHICAGO ST, COLDWATER, MI 49036-2805
(517) 278-8000
(517) 278-8007
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6401009358
MI
207R00000X
Internal Medicine Physician
Primary
5101011799
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114836462
—
MI
Enumeration date
05/18/2009
Last updated
09/23/2009
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