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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