Mark W Russell

MD | Pediatric Cardiology | Male

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Complete Profile:

Mark W Russell basic information including his official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Pediatric Cardiology
Provider Name :	Mark W Russell
Credential :	MD
Gender :	Male

Business Address:

Mark W 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 :	1500 E Medical Center Dr, 11th Floor Cs Mott Childrens Hospital Room 661 Ann Arbor, MI, 48109-5204 United States
Phone Number :	734-764-5176

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 :	1083620256
NPI Entity Type :	Individual
First Enrolment Date :	31 Jul, 2006
Last Updated On :	29 Apr, 2013

Medicare Participation:

Mark W Russell participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	3971645631
Medicare Enrollment ID :	I20100119000752
Primary Specialty :	Pediatric Medicine
Medical School :	Duke University School Of Medicine
Graduation Year :	1989
Accepts Medicare?	Yes. Mark W Russell accepts medicare insurance.

Group Practice Association:

Mark W Russell is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Mark W Russell is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr 2nd Floor Recp A Ann Arbor, MI - 481090999	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr 2nd Floor Recp B Ann Arbor, MI - 481090999	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Suite 0331 Ann Arbor, MI - 481090999 Ph: 7349365738	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr 2nd Lr Rm C213 Recp C Med Inn Ann Arbor, MI - 481090999 Ph: 7347635459	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr 1st Floor Recp C Ann Arbor, MI - 481090999	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr Ann Arbor, MI - 481090999	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr 1st Floor Recp D Taubman Center Ann Arbor, MI - 481090999	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr B1 Floor Recp Emergency University Hosptial Ann Arbor, MI - 481090999 Ph: 7349366666	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr 1st Floor Recp E Ann Arbor, MI - 481090999	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr 1st Floor Ann Arbor, MI - 481090999	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr 2nd Floor Recp F Taubman Center Ann Arbor, MI - 481090999 Ph: 7349365823	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr 2nd Floor Recp G Taubman Center Ann Arbor, MI - 481090999 Ph: 7349365020	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr 1st Floor Recp G Ann Arbor, MI - 481090999	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr 1st Floor Emg Lab University Hospital Ann Arbor, MI - 481090999 Ph: 7349367184	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr Level 358 Cancer And Geriatrics Center Ann Arbor, MI - 481090999 Ph: 7346478901	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr 2nd Floor Recp 2b355 University Hopital Ann Arbor, MI - 481090999 Ph: 7349369250	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr 1st Floor Room Ann Arbor, MI - 481090999	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr 3rd Fl Taubman Ctr Recp A Ann Arbor, MI - 481095000 Ph: 7346477321	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr Ann Arbor, MI - 481095000	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr 1st Fl Rec D Taubman Center Ann Arbor, MI - 481095000 Ph: 7347645175	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr 1st Fl Taubman Ctr Rec D Ann Arbor, MI - 481095000 Ph: 7349364185	Yes
Regents Of The University Of Michigan	3779496856	2855	1500 E Medical Ctr Dr 1st Fl Rec F Mott Hospital Ann Arbor, MI - 481095000 Ph: 7347645176	Yes

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 Mark W Russell are as mentioned. Primary taxonomy code for Mark W Russell, MD is 2080P0202X (Pediatrics Pediatric Cardiology).

Taxonomy Code	Speciality	Primary	License No.	State
208000000X	Pediatrics	No	4301060392	MI
2080P0202X	Pediatrics Pediatric Cardiology	Yes	4301060392	MI

Legacy Identifiers:

Other legacy medical identifiers of Mark W Russell such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.

Identifier	Identifier Type	State	Issuer
3226763	MEDICAID	MI

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 :	3621 S State St, 700 Kms Place Ann Arbor, MI, 48108 United States
Phone Number :	734-936-2047

Business Location:

Patients can refer following map for directions to Mark W 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. Last updated on 08 January, 2024.