Dr Benjamin Lincoln Russell, DO | |
195 Fore River Pkwy, Suite 420, Portland, ME 04102-2780 | |
(207) 553-6500 | |
(207) 553-6520 |
Full Name | Dr Benjamin Lincoln Russell |
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Gender | Male |
Speciality | Surgery |
Location | 195 Fore River Pkwy, Portland, Maine |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033134796 | NPI | - | NPPES |
245010099 | Medicaid | ME |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 1178 (Maine) | Primary |
Entity Name | Mercy Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629078712 PECOS PAC ID: 6103737812 Enrollment ID: O20040217000943 |
Mailing Address | Practice Location Address |
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Dr Benjamin Lincoln Russell, DO 195 Fore River Pkwy, Suite 420, Portland, ME 04102-2780 Ph: (207) 553-6500 | Dr Benjamin Lincoln Russell, DO 195 Fore River Pkwy, Suite 420, Portland, ME 04102-2780 Ph: (207) 553-6500 |
Virginia A Eddy, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 887 Congress St., Portland, ME 04102 Phone: 207-774-2311 | |
Leslie S Wu, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 887 Congress St, Suite 400, Portland, ME 04102 Phone: 207-774-6368 Fax: 207-774-9388 | |
Dr. Forest Raymond Sheppard, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 887 Congress St Ste 210, Portland, ME 04102 Phone: 207-774-6368 Fax: 207-774-9388 | |
Dr. Stacey Anne Rotta, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 887 Congress St, Portland, ME 04102 Phone: 207-774-6368 | |
Dr. Laura Teresa Withers, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 887 Congress St Ste 210, Portland, ME 04102 Phone: 207-774-2381 | |
Ms. Daly Anne Johnson, PA-C Surgery Medicare: Medicare Enrolled Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-0111 |