Individual
CHRISTOPHER ROSS RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
710 KENMOOR AVE SE, SUITE 200, GRAND RAPIDS, MI 49546-2379
(616) 588-7246
(616) 588-7086
Mailing address
710 KENMOOR AVE SE, SUITE 200, GRAND RAPIDS, MI 49546-2379
(616) 588-7246
(616) 588-7086
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
4301064161
MI
208VP0014X
Interventional Pain Medicine Physician
Primary
4301064161
MI
Other
Enumeration date
09/08/2009
Last updated
04/12/2012
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