Organization
RUSSELL G. GADDY M.D.
Active
Other names
WINCHESTER FAMILY MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL G. GADDY MD (DR)
(864) 458-9999
Entity
Organization
Contact information
Practice address
10 WINCHESTER CT, MAULDIN, SC 29662-2627
(864) 458-9999
(864) 234-7652
Mailing address
10 WINCHESTER CT, MAULDIN, SC 29662-2627
(864) 458-9999
(864) 234-7652
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
007870
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007870
—
SC
01
—
207QG0300X
TAXONOMY CODE
SC
01
—
CM7824
MEDICARE RAILROAD
SC
Enumeration date
10/18/2007
Last updated
01/07/2013
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