Provider Demographics
NPI:1790213288
Name:VAN COEVERING, RUSSELL JAMES III (MD, MBA)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:JAMES
Last Name:VAN COEVERING
Suffix:III
Gender:M
Credentials:MD, MBA
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Mailing Address - Street 1:1155 MILL ST
Mailing Address - Street 2:MS M-14
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-4196
Practice Address - Street 1:1155 MILL ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1576
Practice Address - Country:US
Practice Address - Phone:775-982-7878
Practice Address - Fax:775-982-4196
Is Sole Proprietor?:No
Enumeration Date:2017-05-26
Last Update Date:2023-07-24
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Provider Licenses
StateLicense IDTaxonomies
CODR.00684982084V0102X
NV240472084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology