Individual
DR. LORENZO JOSEPH-GERARD RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15855 19 MILE RD, CLINTON TOWNSHIP, MI 48038-3504
(586) 263-2971
Mailing address
15855 19 MILE RD, CLINTON TOWNSHIP, MI 48038-3504
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301513734
MI
Other
Enumeration date
03/29/2023
Last updated
02/12/2025
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