Dr. Gary J Russell
MD | Pediatric Gastroenterology | Male
Dr. Gary J Russell, MD is a Boston, Massachusetts based Pediatric doctor with medical specialization in
Pediatric Gastroenterology.
Current practice location of Dr. Gary J Russell is
55 Fruit St, Yaw 6, Boston, Massachusetts - 02114-2621. He can be contacted on phone at
617-726-8705 and fax number 617-724-2710.
Dr. Gary J Russell is a sole proprietor of his business.
NPI number (Unique professional ID) for Dr. Gary J Russell is
1669463550 which was assigned by NPPES on 31 Oct, 2005 and it was last updated on 01 Aug, 2012.
Dr. Gary J Russell license number is
57051 for Pediatrics Pediatric Gastroenterology (2080P0206X) in Massachusetts.
Dr. Gary J Russell specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.
Complete Profile:
Dr. Gary J Russell basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Pediatric Gastroenterology |
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| Provider Name : | Dr. Gary J Russell |
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| Credential : | MD |
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| Gender : | Male |
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Business Address:
Dr. Gary J Russell address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 55 Fruit St, Yaw 6
Boston, MA, 02114-2621
United States |
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| Phone Number : | 617-726-8705 |
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| Fax Number : | 617-724-2710 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1669463550 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 31 Oct, 2005 |
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| Last Updated On : | 01 Aug, 2012 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Gary J Russell are as mentioned. Primary taxonomy code for Dr. Gary J Russell, MD is
2080P0206X (Pediatrics Pediatric Gastroenterology).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | No | 57051 | MA |
| 2080P0206X | Pediatrics Pediatric Gastroenterology | Yes | 57051 | MA |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Gary J Russell such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| J07673 | Other | MA | BCBS MA |
| 3036430 | MEDICAID | MA | |
| 057051 | Other | MA | TUFTS HEALTH PLAN |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | Po Box 9142
Charlestown, MA, 02129-9142
United States |
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| Phone Number : | 617-726-8705 |
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| Fax Number : | 617-724-2710 |
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Business Location:
Patients can refer following map for directions to
Dr. Gary J Russell practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.