Individual
MICHAEL B RUSSO
Active
Individual
MICHAEL B RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD14968
HI
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
MD14968
HI
Other
Enumeration date
01/26/2006
Last updated
05/19/2020
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