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NPI Code Detail

MEDICARE: DR. RUSSELL EDWARD SPIETH PHD

MEDICARE:  DR. RUSSELL EDWARD SPIETH  PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC1900XCounseling PsychologistP.07811OH

General Provider Information

NPI Number : 1760015978
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RUSSELL EDWARD SPIETH PHD
Provider Business Mailing Address
First Line : 8040 CORPORATE CIR
Second Line :
City : NORTH ROYALTON
State : OH
Zip : 44133-1282
Country : US
Telephone Number : 216-320-9621
Fax Number :
Provider Business Practice Location Address
First Line : 8040 CORPORATE CIR
Second Line :
City : NORTH ROYALTON
State : OH
Zip : 44133-1282
Country : US
Telephone Number : 216-320-9621
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2020
Last Update Date : 10/27/2021

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Directions to “ DR. RUSSELL EDWARD SPIETH PHD” Practice Location

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