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1588668529
ROGER BIVINS RUSSELL
RALEIGH, NC
NPI
1588668529
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2086S0122X Surgery Plastic and Reconstructive Surgery
(Licence: NC 27515)
Enumeration Date
2005-06-08
Last Update Date
2010-12-29
Business Address
ROGER BIVINS RUSSELL MD
3633 HARDEN RD STE 200
RALEIGH, NC 27607-3369
Phone number: 919-785-0505
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Mailing Address
ROGER BIVINS RUSSELL MD
3633 HARDEN RD STE 200
RALEIGH, NC 27607-3369
Phone number: 919-785-0505
Copy
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