Individual
CHRISTOPHER RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4402 SHIPYARD BLVD, WILMINGTON, NC 28403-6161
(910) 202-3363
Mailing address
4402 SHIPYARD BLVD, WILMINGTON, NC 28403-6161
(910) 202-3363
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-14160
NC
Other
Enumeration date
12/05/2023
Last updated
06/23/2024
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