Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. RUSSELL WILLIAM LAKE, MD
Active Sole ProprietorFamily Medicine · RICHMOND HILL, GA
Registration Details
- NPI Number
- 1104081082
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 21, 2008 (17.792792777288 yrs)
- Last Updated
- Oct 19, 2021
- Licenses
-
31545 (SC)75198 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
10055 FORD AVENUESUITE 3ARICHMOND HILL, GA, 31324Browse GA providers · Browse ZIP 31324
- Phone
- 9128199601
- Fax
- 9128199605
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
Other Family Medicine Providers in RICHMOND HILL, GA
| Name | Credential | NPI |
|---|---|---|
| DR. GRANT ALLAN FOSTER | M.D. | 1184623720 |
| DR. DERONDA FELICIA BROWN | MD | 1467446286 |
| CAREY LEE CHRISTIANSEN FORD | MD | 1013906130 |
| REGINA BUCKLEY DANDY | DO | 1922064336 |
| DR. PAUL CHI-CHENG LIANG | MD | 1821115585 |
| DR. KRISTINA NICOLE JOHNSON | M.D. | 1841426707 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.