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Michael Russell
NPI 1245414093 · on the registry since 2007 · sole proprietor
Practice
- Address
- 4588 N 23rd St
Milwaukee, WI 53209 - Phone
- (414) 477-4978
- Fax
- (414) 445-1515
Registry record
- Primary taxonomy
- 343900000X
343900000X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-12-27
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 Wisconsin