Individual
DR. ANDREW COLIN RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
28 COUNTRY CLUB VW, EDWARDSVILLE, IL 62025-3626
(573) 424-9110
Mailing address
6800 ILLINOIS 162, MARYVILLE, IL 62062
(618) 288-5711
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036.134694
IL
207P00000X
Emergency Medicine Physician
2012023819
MO
Other
Enumeration date
03/22/2010
Last updated
10/18/2024
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