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General NPI Number Information
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NPI Number | 1801545512
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Entity Type | Individual
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Provider Name | RUSSELL LINDBERGH PLATT III DPM
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Gender | Male
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Dates
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Enumeration Date | 03/21/2022
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 605 GROVE ST
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City | SALISBURY
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State | NC
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Zip | 28144-3233
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Country | US
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Telephone | 704-633-6442
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Fax | 336-716-9253
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Provider Business Mailing Address
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Address Line | MEDICAL CENTER BLVD
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City | WINSTON SALEM
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State | NC
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Zip | 27157-0001
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Country | US
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Telephone | 704-633-6442
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Fax | 336-716-9253
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0000X
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Taxonomy Name | Sports Medicine Podiatrist
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License Number | 868
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 868
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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