Russo, Michael
Russo, Michael is an sole proprietor health care provider with primary practice located at 1111 Medical Center Blvd Suite S-555, Marrero LA 70072-3151. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Russo, Michael can be contacted via phone (504) 349-6808.Contact Information
Primary practice address
1111 Medical Center Blvd Suite S-555
Marrero LA 70072-3151
Phone: (504) 349-6808
Fax: (504) 349-6811
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 21692 | Louisiana |
Profile Details
| NPI number | 1194887125 |
|---|---|
| LBN Legal business name | Russo, Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 15th, 2006 |
| Last updated | May 20th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194887125 | NPPES |
| Louisiana | MEDICAID | 1987051 |
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