Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GLENN GERARD RUSSO, M.D.
ActiveGLENN GERARD RUSSO, M.D. is a Procedural Dermatology healthcare provider located in GRETNA, Louisiana. NPI 1083683445 is currently active in the NPPES registry. Verify at CMS.
Procedural Dermatology · GRETNA, LA
Registration Details
- NPI Number
- 1083683445
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 16, 2006 (20.424094478187 yrs)
- Last Updated
- Feb 3, 2010
- License
-
017336 (LA)
Practice Information
- Address
-
120 MEADOWCREST STSUITE 160GRETNA, LA, 700565255Browse LA providers · Browse ZIP 70056
- Phone
- 5043917620
- Fax
- 5043917624
- Primary Specialty
-
Procedural Dermatology
207NS0135X
Other Procedural Dermatology Providers in GRETNA, LA
| Name | Credential | NPI |
|---|---|---|
| DANIEL A MARSHALL JR. | MD | 1073510798 |
| GORDON J RUSSO | MD | 1083612469 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.