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1790873099
STEVEN L RUSSELL
CHARLESTON, SC
NPI
1790873099
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: SC a281)
Enumeration Date
2006-10-11
Last Update Date
2007-07-09
Business Address
Mr. STEVEN L RUSSELL pa
191 RUTLEDGE AVE
CHARLESTON, SC 29403-5822
Phone number: 843-723-1614
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Mailing Address
Mr. STEVEN L RUSSELL pa
191 RUTLEDGE AVE
CHARLESTON, SC 29403-5822
Phone number: 843-723-1614
Copy
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