Dr Tanya Russo, DO | |
105 Yadkin St, Suite 303, Albemarle, NC 28001-3449 | |
(803) 532-2208 | |
Not Available |
Full Name | Dr Tanya Russo |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 105 Yadkin St, Albemarle, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013906098 | NPI | - | NPPES |
1013906098 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 0574 (South Carolina) | Primary |
208000000X | Pediatrics | 2015-02335 (North Carolina) | Secondary |
Entity Name | Mcleod Health Clarendon |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508218793 PECOS PAC ID: 0840582656 Enrollment ID: O20160915000930 |
Mailing Address | Practice Location Address |
---|---|
Dr Tanya Russo, DO Po Box 601888, Charlotte, NC 28260-1888 Ph: (704) 982-2683 | Dr Tanya Russo, DO 105 Yadkin St, Suite 303, Albemarle, NC 28001-3449 Ph: (803) 532-2208 |
Dr. Linda Williamson Lawrence, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1420 Us Highway 52 North, Suite A, Albemarle, NC 28001 Phone: 704-982-5437 | |
Mr. Lanny Lee Monroe Jr., MD Pediatrics Medicare: Medicare Enrolled Practice Location: 105 Yadkin St, Suite 303, Albemarle, NC 28001 Phone: 704-982-2683 Fax: 704-512-4838 | |
Kristina L. Kelly, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 105 Yadkin St, Ste 303, Albemarle, NC 28001 Phone: 980-323-5400 | |
Lamonica Barnum, Pediatrics Medicare: Medicare Enrolled Practice Location: 105 Yadkin St, Suite 303, Albemarle, NC 28001 Phone: 980-323-5400 | |
Dr. Susan Carol Watson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1420 Us Highway 52 North, Suite A, Albemarle, NC 28001 Phone: 704-982-5437 Fax: 704-982-4843 | |
Elaine M Coats, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 105 Yadkin St, Ste 303, Albemarle, NC 28001 Phone: 980-323-5400 |