# DR. RUSSELL E CARLSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1821103029
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 189175 | NY | Yes |

## Other

- **Enumeration date:** 08/20/2006
- **Last updated:** 10/28/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00025759601 | UNIVERA HEALTHCARE | NY |
| 01 | — | 000526654001 | BLUE CROSS/ BLUE SHIELD | NY |
| 01 | — | 010549324 | UNITED HEALTHCARE | NY |
| 05 | — | 02212417 | — | NY |
| 01 | — | 040426002783 | FIDELIS | NY |
| 01 | — | 2197606 | INDEPENDENT HEALTH | NY |
| 01 | — | 7099868 | GHI | NY |
| 01 | — | 780002093 | RAILROAD MCR | NY |
| 01 | — | PAR05802 | NORTH AMERICAN ADMINISTRT | NY |