Individual
DR. BRADLEY STOKES RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
805 PAMPLICO HWY, FLORENCE, SC 29505-6047
(843) 674-5143
(843) 674-5146
Mailing address
PO BOX 603898, CHARLOTTE, NC 28260-3898
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
21014
SC
207Q00000X
Family Medicine Physician
Primary
21014
SC
Other
Enumeration date
12/09/2005
Last updated
01/25/2021
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