Russo, Randolph B
Russo, Randolph B is an individual health care provider with primary practice located at 1111 Leffingwell Ave Ne , Grand Rapids MI 49525-6406. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Russo, Randolph B can be contacted via phone (616) 459-7101.Contact Information
Primary practice address
1111 Leffingwell Ave Ne
Grand Rapids MI 49525-6406
Phone: (616) 459-7101
Fax: (616) 464-6170
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 4301056466 | Michigan |
Profile Details
| NPI number | 1306833470 |
|---|---|
| LBN Legal business name | Russo, Randolph B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 4th, 2005 |
| Last updated | Dec 9th, 2019 - about 5 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.
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