Individual
RUSSELL MARCUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
800 N FANT ST, ANDERSON, SC 29621-5708
(864) 512-1335
Mailing address
15575 WELLS HWY, SENECA, SC 29678-1664
(864) 886-2000
(864) 888-3618
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2101
SC
363AM0700X
Medical Physician Assistant
2101
SC
Other
Enumeration date
04/15/2014
Last updated
04/09/2020
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