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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. RANDOLPH B RUSSO, MD

Active

DR. RANDOLPH B RUSSO, MD is a Physical Medicine & Rehabilitation healthcare provider located in GRAND RAPIDS, Michigan. NPI 1306833470 is currently active in the NPPES registry. Verify at CMS.

Physical Medicine & Rehabilitation · GRAND RAPIDS, MI

Registration Details

NPI Number
1306833470
Provider Type
Individual
Gender
Male
NPI Issued
Oct 4, 2005 (20.718024444587 yrs)
Last Updated
Dec 9, 2019
License
4301056466 (MI)

Practice Information

Address
1111 LEFFINGWELL AVE NE
GRAND RAPIDS, MI, 495256406
Browse MI providers · Browse ZIP 49525
Phone
6164597101
Fax
6164646170
Primary Specialty
Physical Medicine & Rehabilitation
208100000X

Other Physical Medicine & Rehabilitation Providers in GRAND RAPIDS, MI

Name Credential NPI
JAMES R ELLIS MD 1710975156
RANDAL A PALMITIER MD 1376531855
DR. BENJAMIN LEE RAWSON D.O. 1902889397
ROBERT WICHLACZ MPT 1487629085
RAMIN RAHIMI D.O. 1639146624
DR. RICHARD D BALL M.D. 1679523765
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.