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Individual

MARGARET A. RUSSO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
49 COLUMBUS AVE, NORTHAMPTON, MA 01060-4252
(413) 320-1139
Mailing address
49 COLUMBUS AVE, NORTHAMPTON, MA 01060-4252
(413) 320-1139

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
79902
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110037879A
MA
01
469026
TUFTS
ME
01
J27504
BLUE CROSS AND BLUE SHIEL
MA
Enumeration date
03/08/2006
Last updated
01/27/2016
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