Tanya Russo DO

NPI 1013906098 - Pediatrics - 208000000X

NPI Details
NPI 1013906098
Gender Female
Enumeration Date 10/21/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
120 W CHURCH ST
BATESBURG SC, 29006-2107, US
Phone (803) 532-2208
Fax
Business Location
1797 HOLLY POINT RD
PROSPERITY SC, 29127-7646, US
Phone (803) 364-9391
Fax
Toxanomy
Taxonomy Code 208000000X
License State South Carolina
License Number 0574
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According to our database, Dr. Tanya Russo DO NPI is 1013906098, taxonomy code is 208000000X and license number is 0574, license state is located at South Carolina. Tanya Russo DO physically located at 120 W Church St, Batesburg SC, 29006-2107. NPI Number Tanya Russo DO has the Individual type.

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1013906098 NPI number is provided on an as is basis without warranty of any kind. 1013906098 is maintained by the National Plan & Provider Enumeration System. The contents of Tanya Russo DO are for informational purposes only.