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General NPI Number Information
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NPI Number | 1114487972
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Entity Type | Individual
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Provider Name | RUSSEL DINH MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 2002 MEDICAL PKWY STE 450
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3263
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Country | US
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Telephone | 410-224-6680
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Fax | 800-762-2852
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Provider Business Mailing Address
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Address Line | 420 MOUNTAIN AVE FL 4
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City | NEW PROVIDENCE
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State | NJ
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Zip | 07974-2736
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Country | US
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Telephone | 908-458-8333
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Fax | 908-530-6522
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 0101285261
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD600003666
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | D0102596
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License Number State | MD
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