Individual
JOSEPH M RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
9712 BELAIR RD STE LL3, NOTTINGHAM, MD 21236-1110
(410) 256-6060
Mailing address
1 NORTH MAIN STREET, BEL AIR, MD 21014
(410) 803-0788
(410) 803-1859
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
01096
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
083068200
—
MD
01
—
E602
NATIONAL CAP BLUE
MD
Enumeration date
10/27/2006
Last updated
03/21/2024
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