Individual
VAN RUSSELL WADLINGTON
Active
Individual
VAN RUSSELL WADLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
18187
AL
208D00000X
General Practice Physician
18187
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000046855
—
AL
05
—
009961805
—
AL
01
—
51514426
BLUE CROSS/BLUE SHIELD
AL
01
—
51521246
BLUE CROSS BLUE SHIELD
AL
01
—
51550456
BLUE CROSS/BLUE SHIELD
AL
Enumeration date
04/13/2006
Last updated
12/22/2020
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