Individual
DR. SCOTT MICHAEL RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 879-3000
Mailing address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 879-3265
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2024
ME
Other
Enumeration date
06/22/2006
Last updated
02/16/2018
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