Individual
DR. EDWARD ROSE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5 ORCHARD LN, ROSE VALLEY, PA 19086-6707
(610) 566-6804
Mailing address
5 ORCHARD LN, ROSE VALLEY, PA 19086-6707
(610) 566-6804
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MD014589E
PA
Other
Enumeration date
01/21/2013
Last updated
01/21/2013
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