Individual
DR. RUSSELL RAYMOND SUDA SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 MOORESVILLE RD, KANNAPOLIS, NC 28081-0304
(704) 920-1000
(704) 934-4270
Mailing address
300 MOORESVILLE ROAD, KANNAPOLIS, NC 28081-0304
(704) 920-1000
(704) 920-1002
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
200301416
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135TU
BCBS ID#
NC
05
—
89135TU
—
NC
Enumeration date
02/26/2007
Last updated
04/11/2022
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