Organization
AFFILIATED DERMATOLOGISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES P RUSSELL M.D. (PARTNER/AFFILIATED DERMATOLOGISTS)
(262) 754-4488
Entity
Organization
Contact information
Practice address
N96W17035 DIVISION RD, SUITE A, GERMANTOWN, WI 53022-6419
(262) 754-4488
(262) 754-4940
Mailing address
13800 W NORTH AVE, SUITE 100, BROOKFIELD, WI 53005-4977
(262) 754-4488
(262) 754-4940
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407849011
BILLING NPI NUMBER
WI
Enumeration date
08/22/2014
Last updated
05/28/2021
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