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1619399300
SEAN RUSSELL
RALEIGH, NC
NPI
1619399300
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NC 0010-04739)
Enumeration Date
2014-01-14
Last Update Date
2024-01-07
Business Address
SEAN RUSSELL
5838 SIX FORKS RD STE 100
RALEIGH, NC 27609-3893
Phone number: 919-785-3400
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Mailing Address
SEAN RUSSELL
PO BOX 63082
CHARLOTTE, NC 28263-3949
Phone number: 919-785-3400
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