Individual
RUSSELL CHAPMAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3949 BROWNING PL, RALEIGH, NC 27609-6504
(919) 787-8221
(919) 789-4461
Mailing address
PO BOX 19368, RALEIGH, NC 27619-9368
(919) 787-8221
(919) 789-4461
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138KF
BLUECROSS BLUESHIELD
NC
01
—
2500018
UNITED HEALTHCARE
NC
01
—
6297819
CIGNA
NC
01
—
7146484
AETNA
NC
05
—
89138KF
—
NC
01
—
D8898
MEDCOST
NC
01
—
D9130
MEDCOST
NC
01
—
D9131
MEDCOST
NC
01
—
P00258193
RAILROAD MEDICARE
NC
01
—
P00263266
RAILROAD MEDICARE
NC
Enumeration date
06/07/2006
Last updated
07/08/2007
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