Provider Demographics
NPI:1063566461
Name:HANDY, RUSSELL LEE (MD)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:LEE
Last Name:HANDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5875 BREMO ROAD
Mailing Address - Street 2:SUITE 701
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1934
Mailing Address - Country:US
Mailing Address - Phone:804-282-8350
Mailing Address - Fax:804-282-6506
Practice Address - Street 1:5875 BREMO ROAD
Practice Address - Street 2:SUITE 701
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1934
Practice Address - Country:US
Practice Address - Phone:804-282-8350
Practice Address - Fax:804-282-6506
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101036484207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
57740OtherSOUTHERN HEALTH
VA6243410Medicaid
0539488OtherAETNA
247163OtherANTHEM
21655OtherMAMSI
247163OtherANTHEM