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Individual

DR. OLEG A ROUSSANOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 224-1986
Mailing address
1970 ROANOKE BLVD, SALEM, VA 24153-6404

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01057953A
IN

Other

Enumeration date
12/26/2007
Last updated
12/26/2007
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