Russell, Erich

Russell, Erich is an individual health care provider with primary practice located at 33 Sewall St , Portland ME 04102-2603. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Russell, Erich can be contacted via phone (207) 828-2100.

Contact Information

Primary practice address
33 Sewall St Portland ME 04102-2603
Fax:
Website:

Profile Details

NPI number 1255743605
LBN Legal business name Russell, Erich
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2014
Last updated Jul 7th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255743605 NPPES
Maine MEDICAID 1255743605

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