Individual
ANDREW MARTIN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
200 MUNICIPAL DR, THORNDALE, PA 19372-1058
(610) 383-6300
Mailing address
200 MUNICIPAL DR, THORNDALE, PA 19372-1058
(610) 383-6300
(610) 383-0114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MA061552
PA
Other
Enumeration date
06/24/2020
Last updated
06/24/2020
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