Individual
SETH RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
96 JONATHAN LUCAS ST, CHARLESTON, SC 29425-2134
(843) 792-7179
Mailing address
96 JONATHAN LUCAS ST, CHARLESTON, SC 29425-8900
(843) 792-7179
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
261546
NC
2085R0202X
Diagnostic Radiology Physician
Primary
LL86177
SC
Other
Enumeration date
04/02/2020
Last updated
04/05/2023
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