Russo, Scott S

Russo, Scott S is an individual health care provider with primary practice located at 750 E Beltline Ave Ne Suite 301, Grand Rapids MI 49525-6049. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine, which is considered as his primary health care specialty. Russo, Scott S can be contacted via phone (616) 459-7101.

Contact Information

Primary practice address
750 E Beltline Ave Ne Suite 301 Grand Rapids MI 49525-6049
Phone: (616) 459-7101
Fax: (616) 942-6879
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine 207XS0117X 4301405099 Michigan

Profile Details

NPI number 1942298369
LBN Legal business name Russo, Scott S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2005
Last updated Feb 4th, 2013 - about 11 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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Identifiers

StateTypeNumberIssuer
All States NPI 1942298369 NPPES
Michigan MEDICAID 4761530

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