Individual
MR. PETER JOHN RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
55 W WATERLOO RD, AKRON, OH 44319-1116
(330) 724-7715
Mailing address
211 RIDGE RD, MOGADORE, OH 44260-2022
(330) 628-5508
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.000448
OH
Other
Enumeration date
10/13/2006
Last updated
07/08/2007
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