Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. SAMUEL J. RUSSO, DO
ActiveDR. SAMUEL J. RUSSO, DO is a Family Medicine healthcare provider located in ELMIRA, Michigan. NPI 1962510636 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · ELMIRA, MI
Registration Details
- NPI Number
- 1962510636
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 25, 2006 (19.980268379393 yrs)
- Last Updated
- Dec 3, 2013
- Licenses
-
DO15969 (OR)5101008981 (MI)
Practice Information
- Address
-
2572 N US HIGHWAY 131ELMIRA, MI, 497308252Browse MI providers · Browse ZIP 49730
- Phone
- 9897317700
- Fax
- 9897312999
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
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.