Russell, Alexander S

Russell, Alexander S is an individual health care provider with primary practice located at 2799 W Grand Blvd , Detroit MI 48202. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Russell, Alexander S can be contacted via phone (313) 874-4696.

Contact Information

Primary practice address
2799 W Grand Blvd Detroit MI 48202
Phone: (313) 874-4696
Fax: (313) 874-4677
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 50.005155RX Ohio
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601008724 Michigan

Profile Details

NPI number 1659895993
LBN Legal business name Russell, Alexander S
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2017
Last updated Jul 25th, 2018 - about 8 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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