Individual
DONALD L. RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 MEDICAL PARK DR, DOVER, OH 44622-3207
(330) 454-8076
(330) 454-3927
Mailing address
2600 6TH ST SW, SUITE A2-710, CANTON, OH 44710-1702
(330) 454-8076
(330) 454-3927
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-04-6531
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0556483
—
OH
Enumeration date
01/11/2006
Last updated
02/10/2021
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