Individual
MICHAEL RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3700 KOLBE RD, LORAIN, OH 44053-1611
(440) 323-8515
Mailing address
24640 SURREY CIR, WESTLAKE, OH 44145-4956
(440) 610-4301
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
125069843
IL
207L00000X
Anesthesiology Physician
Primary
35.137494
OH
Other
Enumeration date
05/25/2016
Last updated
08/13/2020
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