Individual
RUSSELL P. SENECA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4001 FAIR RIDGE DR, SUITE 304, FAIRFAX, VA 22033-2917
(703) 359-8640
(703) 591-6105
Mailing address
4001 FAIR RIDGE DR, SUITE 304, FAIRFAX, VA 22033-2917
(703) 359-8640
(703) 591-6105
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101019015
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7379056
—
VA
Enumeration date
09/22/2005
Last updated
07/08/2007
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