Mr Andrew Wray Russ, PA-C is a
Physician Assistant - Medical based in Redlands, California. Mr Andrew Wray Russ is licensed to practice in California (license number PA53942) and his current practice location is
124 E Olive Ave, Redlands, California. He can be reached at his office (for appointments etc.) via phone at
(909) 798-9403.
NPI number for Mr Andrew Wray Russ is 1457895054 and his current mailing address is 223 Belmont Ct, Redlands, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1457895054.
Healthcare Provider's Profile
| Full Name | Mr Andrew Wray Russ |
|---|
| Gender | Male |
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| Speciality | Physician Assistant - Medical |
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| Location | 124 E Olive Ave, Redlands, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1457895054
- Provider Enumeration Date: 12/15/2016
- Last Update Date: 12/15/2016
Medical Identifiers
Medical identifiers for Mr Andrew Wray Russ such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457895054 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 133V00000X | Dietitian, Registered | 01024357 (California) | Secondary |
| 363AM0700X | Physician Assistant - Medical | PA53942 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Andrew Wray Russ is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Andrew Wray Russ, PA-C
223 Belmont Ct,
Redlands, CA 92373-7118
Ph: (909) 644-6420 | Mr Andrew Wray Russ, PA-C
124 E Olive Ave,
Redlands, CA 92373-5250
Ph: (909) 798-9403 |
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