Individual
CALVIN RUSSELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1391 N BALDWIN AVE, MARION, IN 46952-1913
(765) 662-2534
Mailing address
1391 N BALDWIN AVE, MARION, IN 46952-1913
(765) 662-2534
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01024365
IN
Other
Enumeration date
01/25/2006
Last updated
07/08/2007
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