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Individual

MICHAEL JAMES RUSSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA C

Contact information

Practice address
1675 WOODBROOKE DR, SALISBURY, MD 21804-8502
(410) 749-4154
(410) 860-9583
Mailing address
PO BOX 69709, BALTIMORE, MD 21264-9709
(410) 749-4154
(410) 860-9583

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C03866
MD

Other

Enumeration date
09/29/2008
Last updated
08/15/2025
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