Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | D75134 | MD |
N | 208200000X | Surgeon | 694101813 | MD |
N | 208600000X | Surgeon | 694101813 | MD |
NPI | 1124262951 |
---|---|
Provider Name | Dr. Russell Noel Wesson |
First Address | Baltimore, MD 21287-0005 |
Second Address | Baltimore, MD 21287-0005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2009 |
Last Update Date | 19/08/2016 |