Organization
MICHAEL B. RUSSO MD INC
Active
Parent organization
MICHAEL B. RUSSO MD INC
Other names
Hawaii Pacific DEEG
Organization subpart
Yes
Provider details
NPI number
Legal business name
MICHAEL B. RUSSO MD INC
Authorized official
DR. MICHAEL B. RUSSO MD (OWNER)
(808) 294-3332
Entity
Organization
Contact information
Practice address
320 WARD AVE, SUITE 101, HONOLULU, HI 96814-4001
(808) 294-3332
(808) 748-2920
Mailing address
8513 NE HAZEL DELL AVE, SUITE #102, VANCOUVER, WA 98665-8068
(360) 450-3926
(360) 450-3926
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
10/17/2012
Last updated
10/26/2015
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