Russell Glen Medders in Raleigh - Otolaryngology
Russell Glen Medders - NPI 1376501049
Russell Glen Medders is a Otolaryngology in Raleigh, North Carolina. Russell Glen Medders practices all healthcare services and medical treatments related to Otolaryngology. The NPI Number for Russell Glen Medders is 1376501049. The last update date is 2021-07-09.
Russell Glen Medders's current location address is 4600 Lake Boone Trail, Raleigh, North Carolina. You can contact this provider via phone number 9197871374 and fax number 9195718135. The mailing address for Russell Glen Medders is 4600 Lake Boone Trail, Raleigh, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Russell Glen Medders |
|---|---|
| Address | 4600 Lake Boone Trail, Raleigh, North Carolina |
| Phone Number | 9197871374 |
| Fax Number | 9195718135 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1376501049 |
|---|---|
| Provider Enumeration Date | 2006-05-03 |
| Last Updated Date | 2021-07-09 |
Provider Mailing Address Detail
| Address | 4600 Lake Boone Trail |
|---|---|
| City | Raleigh |
| State | North Carolina (NC) |
| Post Code | 276077529 |
| Phone Number | 9197871374 |
| Fax Number | 9195718135 |
Provider's Primary Taxonomy Detail
| Speciality | Otolaryngology |
|---|---|
| Taxonomy | 207Y00000X |
| Licence No | 29710 |
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Definition: An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head an |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 40002669 | NC | RAILROAD MEDICARE | |
| 1050117 | NC | UNITED HEALTHCARE | |
| 8958402 | NC | -- | |
| 58402 | NC | BLUE CROSS |
Post Comment/ Review Below
What is the unique identifier code issued to Russell Glen Medders by the Centers for Medicare & Medicaid Services (CMS)?
The Russell Glen Medders has been assigned the NPI (National Provider Identifier) 1376501049. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete address where Russell Glen Medders is physically located?
The Russell Glen Medders is situated at the following address: 4600 Lake Boone Trail, Raleigh, NC 276077529.
What is Russell Glen Medders's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Russell Glen Medders is Otolaryngology, and the taxonomy classification code that categorizes this area of expertise is 207Y00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1376501049 to Russell Glen Medders?
The Russell Glen Medders received its 1376501049 assignment from the Centers for Medicare & Medicaid Services on 2006-05-03.
When was the information pertaining to Russell Glen Medders most recently updated or revised?
The details related to Russell Glen Medders, including its address, specialty, and other relevant information, were last updated or revised on 2021-07-09.
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