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Phillip Russell, O.D
NPI 1245244326 · on the registry since 2006 · sole proprietor
Practice
- Address
- 16006 Crain Hwy
Brandywine, MD 20613 - Phone
- (301) 372-3213
- Fax
- (301) 372-3214
- Organisation at this address
- Costco Wholesale Corporation
Costco Wholesale CorporationInferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 152W00000X
152W00000X
- Licence states on file
- MD
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-10-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Maryland