Individual
RUSSELL E BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
137 MEDICAL LANE, POLLOCKSVILLE, NC 28573
(252) 633-1010
(252) 224-3071
Mailing address
PO BOX 68, POLLOCKSVILLE, NC 28573-0068
(252) 633-1010
(252) 224-3071
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
19319
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131F9
BLUE CROSS
NC
05
—
89131F9
—
NC
Enumeration date
08/30/2005
Last updated
04/11/2008
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