Individual
SUZANNE M RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3951
Mailing address
20800 HARVARD RD, 2ND FLOOR, HIGHLAND HILLS, OH 44122-7202
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
19098
MS
2085R0001X
Radiation Oncology Physician
24394
AL
2085R0001X
Radiation Oncology Physician
Primary
35.125723
OH
2085R0001X
Radiation Oncology Physician
40280
TN
2085R0001X
Radiation Oncology Physician
97-00385
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0135692
—
OH
01
—
051513420
BLUE CROSS
AL
01
—
126MH
BCBS
NC
05
—
89126MH
—
NC
01
—
920006473
RAILROAD MEDICARE
AL
Enumeration date
07/13/2006
Last updated
12/01/2020
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