Individual
TERRI ANN LA RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
701 GROVE RD, 5TH FLOOR, GREENVILLE, SC 29605-4210
(864) 455-7000
Mailing address
1 INDEPENDENCE PT, STE 212, GREENVILLE, SC 29615-4536
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4760
SC
208M00000X
Hospitalist Physician
Primary
4760
SC
Other
Enumeration date
06/16/2009
Last updated
05/14/2019
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