Individual
DR. MICHAEL ERIC RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3401 CIVIC CENTER BLVD, DIVISION OF INFECTIOUS DISEASES, PHILADELPHIA, PA 19104
(215) 590-1000
Mailing address
3401 CIVIC CENTER BLVD, DIVISION OF INFECTIOUS DISEASES, PHILADELPHIA, PA 19104-4319
(609) 575-5895
Taxonomy
Speciality
Code
Description
License number
State
2080P0208X
Pediatric Infectious Diseases Physician
Primary
MD465279
PA
Other
Enumeration date
03/25/2011
Last updated
08/09/2018
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