Provider Demographics
NPI:1629288246
Name:CANHAM, RUSSELL M (MD)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:M
Last Name:CANHAM
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:3650 W. WHEATLAND RD.
Mailing Address - Street 2:SUITE C
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-1259
Mailing Address - Country:US
Mailing Address - Phone:214-774-9771
Mailing Address - Fax:214-774-9762
Practice Address - Street 1:3650 W. WHEATLAND RD.
Practice Address - Street 2:SUITE C
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-1259
Practice Address - Country:US
Practice Address - Phone:214-774-9771
Practice Address - Fax:214-774-9762
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2016-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM2274207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease