person
Mr. Brent Charles Russell, PA-C
Medical Physician Assistant in Sterling Heights, Michigan
NPI 1255412318

Brent Charles Russell is a Medical Physician Assistant based in Hartland, MI and is specialized in Medical. Brent Charles Russell practices in Sterling Heights, MI and has the professional credentials of PA-C. The NPI Number for Brent Charles Russell is 1255412318 and holds a License No. 5601002647 (Michigan).

The current practice location address for Brent Charles Russell is 43145 Schoenherr Rd, Sterling Heights, MI and can be reached out via phone at 589-997-5048 and via fax at 589-997-5049. You can also correspond with Brent Charles Russell through the mailing address at 12685 HIGHLAND RD, HARTLAND, MI - 48353-2933 (mailing address contact number: 419-865-4448).

Location: 43145 Schoenherr Rd, Sterling Heights, MI, 48353-2933
person
Provider Profile Details
NPI Number
1255412318
Provider Name
Brent Charles Russell
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
43145 Schoenherr Rd, Sterling Heights, MI, 48353-2933
Phone Number
589-997-5048
Fax Number
589-997-5049
Provider Enumeration Date
10/17/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
55.000448 01 OH CERTIFICATE TO PRESCRIBE
5601002647 01 MI PAIN MANAGEMENT
institution
Provider Business Practice Location Address Details
Address
43145 Schoenherr Rd
City
State
Zip
48313-1955
Phone Number
589-997-5048
Fax Number
589-997-5049
person
Provider Business Mailing Address Details
Address
12685 Highland Rd
City
State
Zip
48353-2933
Phone Number
419-865-4448
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
5601002647 (Michigan)
Definition
Definition to come...
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