Individual
RUSSELL HARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1135 CARTHAGE ST, SANFORD, NC 27330-4162
(919) 774-2261
Mailing address
7 PLOWLAN PL, DURHAM, NC 27707-2438
(919) 489-1728
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
28109
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39635
BLUE SHIELD
NC
05
—
8939635
—
NC
Enumeration date
06/02/2006
Last updated
07/08/2007
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