# MICHAEL B. RUSSO MD INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MICHAEL B. RUSSO MD INC
- **Other names:** Hawaii Pacific DEEG
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1477806214
- **Legal business name:** MICHAEL B. RUSSO MD INC
- **Authorized official:** DR. MICHAEL B. RUSSO MD (OWNER)
- **Authorized official phone:** (808) 294-3332

## Contact information

- **Practice address:** 320 WARD AVE, SUITE 101, HONOLULU, HI 96814-4001
- **Practice address phone:** (808) 294-3332
- **Practice address fax:** (808) 748-2920
- **Mailing address:** 8513 NE HAZEL DELL AVE, SUITE \#102, VANCOUVER, WA 98665-8068
- **Mailing address phone:** (360) 450-3926
- **Mailing address fax:** (360) 450-3926

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 10/17/2012
- **Last updated:** 10/26/2015