Individual provider · Type 1 NPI

Amorette D. Russell, P.A.

Surgical Physician Assistant · St. Louis, MO

NPI number 1225000102 Active

Practice location

625 S New Ballas Rd, Suite R-7040
St. Louis, MO 63141-8232

Fax (314) 251-1053

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X2003025349 (MO)

Surgical Physician Assistant: Definition to come...

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About NPI 1225000102

Amorette D. Russell, P.A.'s National Provider Identifier is 1225000102, issued on Feb 3, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in St. Louis, MO. The record was last updated on Jul 8, 2007.