Individual provider · Type 1 NPI

J. Maxwell Russell Iv, DO

Student in an Organized Health Care Education/Training Program · Portland, ME

NPI number 1275472375 Active

Practice location

22 Bramhall St
Portland, ME 04102-3175

Call (207) 662-0111 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1275472375

J. Maxwell Russell Iv, DO's National Provider Identifier is 1275472375, issued on Mar 25, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Portland, ME. The record was last updated on Mar 25, 2026.