Dr. Bradley Stokes Russell, MD
Family Medicine in Florence, SC. Individual provider (NPI-1).
NPI number1528043759
StatusActive
Last updated in NPPESJan 25, 2021
Details
- NPI
- 1528043759
- Entity type
- Individual (NPI-1)
- Name
- Dr. Bradley Stokes Russell
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 9, 2005
- Certification date
- Jan 25, 2021
- Last updated
- Jan 25, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 21014 | SC | Yes |
| 207P00000X | Emergency Medicine | 21014 | SC |
Practice location
805 Pamplico HwyFlorence, SC 29505-6047
Phone 843-674-5143 · Fax 843-674-5146
Mailing address
Po Box 603898Charlotte, NC 28260-3898
Phone 843-792-6200
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