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1518394204
JEFFREY DANE RUSSELL
BALTIMORE, MD
NPI
1518394204
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MD C0005160)
Enumeration Date
2013-09-26
Last Update Date
2013-09-26
Business Address
-- JEFFREY DANE RUSSELL PA-C
900 CATON AVE
BALTIMORE, MD 21229-5201
Phone number: 410-368-2000
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Mailing Address
-- JEFFREY DANE RUSSELL PA-C
2100 POWELL ST SUITE 900
EMERYVILLE, CA 94608-1826
Phone number: 510-350-2600
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