Individual
RUSSELL ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
514 NORTH BRIGHTLEAF BLVD SUITE 1100, SMITHFIELD, NC 27577
(919) 989-2192
Mailing address
JOHNSTON CANCER CENTER, 514 N BRIGHTLEAF BLVD STE 1100, SMITHFIELD, NC 27577
(919) 989-2192
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
98-00446
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891139T
—
NC
Enumeration date
11/29/2006
Last updated
10/24/2007
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