| Fredrick Russek, MD | |
| 
					5263 S Highway 95, Suite 101, Fort Mohave, AZ 86426-9223  | |
| (928) 788-3333 | |
| (928) 788-3555 | 
| Full Name | Fredrick Russek | 
|---|---|
| Gender | Male | 
| Speciality | Anesthesiology - Pain Medicine | 
| Location | 5263 S Highway 95, Fort Mohave, Arizona | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1285610170 | NPI | - | NPPES | 
| 002002781 | Medicaid | NV | |
| 256661 | Medicaid | AZ | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207L00000X | Anesthesiology | 582 (Nevada) | Secondary | 
| 207LP2900X | Anesthesiology - Pain Medicine | 2202 (Arizona) | Primary | 
| Entity Name | Vhs Outpatient Clinics Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1912979964 PECOS PAC ID: 4486566726 Enrollment ID: O20031104000523  | 
| Entity Name | Arizona Advanced Anesthesia Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1134479892 PECOS PAC ID: 0941454953 Enrollment ID: O20130129000024  | 
| Entity Name | Grand Canyon Anesthesia Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1356822902 PECOS PAC ID: 3678824752 Enrollment ID: O20180928002378  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Fredrick Russek, MD Po Box 10966, Suite 101, Fort Mohave, AZ 86427-0966 Ph: (928) 788-3333  | Fredrick Russek, MD 5263 S Highway 95, Suite 101, Fort Mohave, AZ 86426-9223 Ph: (928) 788-3333  | 
Dr. Henry H Liang, D.O. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 4825 S Highway 95 # 2-356, Fort Mohave, AZ 86426 Phone: 888-206-5902 Fax: 480-466-7536  | |
Oleg V Serbine, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1510 E Wagon Wheel Ln, Ste. 110, Fort Mohave, AZ 86426 Phone: 928-788-3333 Fax: 928-788-3555  | |
Dr. Mervat Basta, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 4825 S Highway 95 # 2-356, Fort Mohave, AZ 86426 Phone: 888-206-5902 Fax: 480-466-7536  | |
Dr. Scott Duong, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 4825 S Highway 95 # 2-356, Fort Mohave, AZ 86426 Phone: 888-206-5902 Fax: 480-466-7536  | |
Francisco J. Melo, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 4825 S Highway 95 # 2-356, Fort Mohave, AZ 86426 Phone: 888-206-5902 Fax: 480-466-7536  | |
Dr. Nitish Aggarwal, MD/MBA Anesthesiology Medicare: Medicare Enrolled Practice Location: 1510 E Wagon Wheel Ln Ste 110, Fort Mohave, AZ 86426 Phone: 928-788-3333 Fax: 928-788-3555  |