Provider Demographics
NPI:1720220577
Name:FIORE, RUSSELL R (MD)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:R
Last Name:FIORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 MEADOWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4738
Mailing Address - Country:US
Mailing Address - Phone:603-778-0055
Mailing Address - Fax:603-778-0666
Practice Address - Street 1:36 MEADOWOOD DR
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4738
Practice Address - Country:US
Practice Address - Phone:603-778-0055
Practice Address - Fax:603-778-0666
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY102290-1207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease