Healthcare Provider Details

I. General information

NPI: 1497994784
Provider Name (Legal Business Name): HYDE M RUSSELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2009
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 MCDOWELL ST
ASHEVILLE NC
28803-2606
US

IV. Provider business mailing address

257 MCDOWELL ST
ASHEVILLE NC
28803-2606
US

V. Phone/Fax

Practice location:
  • Phone: 828-258-1121
  • Fax: 828-252-6114
Mailing address:
  • Phone: 828-258-1121
  • Fax: 828-252-6114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number036-108346
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: