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Organization

DEBORAH L RUSSELL MD PLLC

Active
Other names
Deborah L Russell MD and Paul A Meyer MD PC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DEBORAH LEE RUSSELL MD (OWNER)
(989) 791-9100
Entity
Organization

Contact information

Practice address
4177 FASHION SQUARE BLVD., SUITE # 1, SAGINAW, MI 48603-5216
(989) 791-9100
(989) 791-6746
Mailing address
4177 FASHION SQUARE BLVD., SUITE # 1, SAGINAW, MI 48603-5216
(989) 791-9100
(989) 791-6746

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
4301053500
MI
207VG0400X
Gynecology Physician
Primary
363LF0000X
Family Nurse Practitioner
4704246844
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3170069
MI
01
700G310050
BCBSM
MI
Enumeration date
03/20/2007
Last updated
08/24/2021
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