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ANTHONY MICHAEL RUSSO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-5000
Mailing address
7760 ORCHARD LN, WASHINGTON, MI 48095-1113
(586) 838-8522

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
4704317005
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
1750950275
MI
367500000X
Certified Registered Nurse Anesthetist
APRN11029309
FL

Other

Enumeration date
06/19/2021
Last updated
09/27/2024
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