Individual
RUSSELL JEFFREY SEYMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-1414
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
13325
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133251
—
SC
Enumeration date
10/03/2006
Last updated
12/06/2017
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