IndividualActive
George Russell, MD
NPI 1366423154 · Pediatric Gastroenterology Physician · Portland, ME
Provider details
- NPI number
- 1366423154
- Entity type
- Individual
- Primary specialty
- Pediatric Gastroenterology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 213288 (MA)
Practice location
887 Congress St
Suite 320
Portland, ME 04102-3100
Phone: (207) 662-5522
Fax: (207) 662-5227
Mailing address
300 Southborough Dr
South Portland, ME 04106-6914
Registry dates
- Enumerated
- 2005-11-08
- Last updated
- 2016-08-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.