Provider Demographics
NPI:1568497360
Name:SCHILLING, RUSSELL ALAN (DO)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:ALAN
Last Name:SCHILLING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 S TALBOT ST STE 4
Mailing Address - Street 2:
Mailing Address - City:ST MICHAELS
Mailing Address - State:MD
Mailing Address - Zip Code:21663-2605
Mailing Address - Country:US
Mailing Address - Phone:410-745-0200
Mailing Address - Fax:833-908-2281
Practice Address - Street 1:933 S TALBOT ST STE 4
Practice Address - Street 2:
Practice Address - City:ST MICHAELS
Practice Address - State:MD
Practice Address - Zip Code:21663-2605
Practice Address - Country:US
Practice Address - Phone:410-745-0200
Practice Address - Fax:833-908-2281
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0042587207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD486900100Medicaid
G21371Medicare UPIN
MD486900100Medicaid