| Doctor Name: | DR. HANNAH NIKKOLE RUSSELL |
| NPI Number: | 1083901516 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.O. |
| License Number: | 5101019491 |
| Business Practice Address: | 1000 Harrington St Mount Clemens, MI - 480432920 |
| Business Phone Number: | 5864938000 |
| Business Fax Number: | |
| Mailing Address: | 23416 Clarewood St, MACOMB |
| State: | MI |
| Postal Code: | 480424827 |
| Phone Number: | 5106106007 |
| Fax Number: | |
| NPI Enumeration Date: | 07/05/2011 |
| NPI Last Update Date: | 07/05/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | 5101019491 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |