Individual
DR. ROMOLO HARRIS RUSSO
Active
Individual
DR. ROMOLO HARRIS RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
4301036631
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1403912121
BCBS PIN
MI
01
—
155407
GREAT LAKES HLTH PLN
—
01
—
4325832
AETNA PIN
—
05
—
4832089-10
—
MI
Enumeration date
06/12/2006
Last updated
06/14/2010
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