Individual
SAMANTHA PAIGE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
10 MCCLELLAN BANKS DR MSC 915, CHARLESTON, SC 29425-0001
(571) 271-6310
Mailing address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-8905
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
25MB12561700
NJ
208000000X
Pediatrics Physician
Primary
LL87675
SC
Other
Enumeration date
06/07/2022
Last updated
03/12/2025
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