Individual
DR. RUSSELL A. CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-2775
(570) 271-6367
(570) 271-7142
Mailing address
100 N ACADEMY AVE, CREDENTIALS DEPT, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD440819
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025231760001
—
PA
Enumeration date
06/14/2006
Last updated
10/19/2020
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