MICHAEL JAMES RUSSO (NPI# 1952551749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1952551749 |
Entity Type | Individual |
Full Name | MICHAEL JAMES RUSSO |
Credential | PA C |
Practice Address |
1675 Woodbrooke Dr Salisbury MD 21804-8502 |
Practice Telephone | 4107494154 |
Practice Fax Number | 4108609583 |
Mailing Telephone | 4107494154 |
Mailing Fax Number | 4108609583 |
Enumeration Date | 2008-09-29 |
Last Update Date | 2008-09-29 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
C03866 | MD | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205463486 | Michael Russo | Physical Therapist | 29800 Bainbridge Rd # So40, Solon, OH 44139-2202 | 2020-03-26 |
1982251427 | Michael Russo | Counselor | 17042 Puntledge Dr, Westfield, IN 46062-6521 | 2019-08-20 |
1699947242 | Michael James Russo | Social Worker | 19 Maidstone Ln, Hampton Bays, NY 11946-1670 | 2008-03-24 |
1700084381 | Michael Anthony Russo | Surgery | 1811 Brookfurst St #5600, Fountain Valley, CA 92708-6728 | 2007-07-05 |
1801824362 | Michael Russo | Chiropractor | 12362 Euclid St, Garden Grove, CA 92840-3308 | 2006-06-30 |
1164465571 | Michael Scott Russo | Chiropractor | 100 N Centre Ave, Suite 202, Rockville Centre, NY 11570-3937 | 2006-06-14 |
1619948973 | Michael S. Russo | Physical Therapist | 10 Church Towers, Hoboken, NJ 07030 | 2006-01-26 |
1477523785 | Michael B Russo | Psychiatry & Neurology | 250 Ward Ave Ste 170, Honolulu, HI 96814-4014 | 2006-01-26 |
1558822510 | Michael Jonathan Russo | Student in an Organized Health Care Education/Training Program | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2019-03-30 |
1245720523 | Michael Joseph Russo | Emergency Medicine | 1501 N Campbell Ave, Tucson, AZ 85724-0001 | 2018-05-13 |
Street Address |
1675 WOODBROOKE DR |
City | SALISBURY |
State | MD |
Zip Code | 21804-8502 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316948524 | Kemuel Ray Carey | Specialist/Technologist | 1675 Woodbrooke Dr, Salisbury, MD 21804-8502 | 2005-08-10 |
1740897768 | Katelin Raye Talbert | Physician Assistant | 1675 Woodbrooke Dr, Salisbury, MD 21804-8502 | 2020-09-24 |
1336606979 | Brendan C Gaden | Physician Assistant | 1675 Woodbrooke Dr, Salisbury, MD 21804-8502 | 2019-03-01 |
1861968877 | Victoria Elise Arnao | Orthopaedic Surgery | 1675 Woodbrooke Dr, Salisbury, MD 21804-8502 | 2018-10-17 |
1720564263 | Kevin Aebli | Physician Assistant | 1675 Woodbrooke Dr, Salisbury, MD 21804-8502 | 2018-07-18 |
1548752017 | Stephanie Lynn Taylor | Physician Assistant | 1675 Woodbrooke Dr, Salisbury, MD 21804 | 2018-05-31 |
1912410119 | Paige Marie Venables | Physician Assistant | 1675 Woodbrooke Dr, Salisbury, MD 21804-8502 | 2017-11-09 |
1861913311 | Bo Alan Wilkinson | Orthopaedic Surgery | 1675 Woodbrooke Dr, Salisbury, MD 21804-8502 | 2017-07-05 |
1922403450 | Charles Ellis | Physician Assistant | 1675 Woodbrooke Dr, Salisbury, MD 21804-8502 | 2014-10-27 |
1215359047 | Katelin Whitelock | Physician Assistant | 1675 Woodbrooke Dr, Salisbury, MD 21804-8502 | 2014-01-14 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578125969 | Lifes Energy Wellness Center Inc. | Community/Behavioral Health | 2324 West Zion Road Suite, Suite 112, Salisbury, MD 21804 | 2019-07-05 |
1578125340 | Lifes Energy Wellness Center Inc. | Counselor | 2324 West Zion Road Suite 112, Suite 112, Salisbury, MD 21804 | 2019-07-02 |
1093377855 | Lifes Energy Wellness Center Inc. | Clinic/Center | 2324 West Zion Road Suite #112, Salisbury, MD 21804 | 2019-07-02 |
1356904874 | Carly Showell Finkbeiner | Behavioral Analyst | 30507 Foxchase Dr, Salisbury, MD 21804 | 2019-04-19 |
1750844940 | Clifton Waters | Driver | 206 Davis St, Salisbury, MD 21804 | 2019-04-13 |
1487125415 | Rebecca J. Raygor | Social Worker | Wicomico High School, 201 Long Ave., Salisbury, MD 21804 | 2018-12-17 |
1639662745 | Peninsula Physical Therapy, LLC | Physical Therapist | 720 E College Ave Ste 11, Salisbury, MD 21804 | 2018-06-13 |
1376079533 | Kerry Choplin | Behavior Technician | 8032 Snow Hill Rd., Salisbury, MD 21804 | 2017-05-10 |
1558892992 | Three Lower Counties Community Services, Inc. | Clinic/Center | 1647 Woodbrooke Drive, Salisbury, MD 21804 | 2017-03-27 |
1508304759 | Driven Physiotherapy, LLC | Clinic/Center | 1029 Zircon Ct., Salisbury, MD 21804 | 2017-02-08 |
Find all providers in zip 21804 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740897768 | Katelin Raye Talbert | Physician Assistant | 1675 Woodbrooke Dr, Salisbury, MD 21804-8502 | 2020-09-24 |
1720564263 | Kevin Aebli | Physician Assistant | 1675 Woodbrooke Dr, Salisbury, MD 21804-8502 | 2018-07-18 |
1578914263 | David Carsen Hyde | Physician Assistant | 100 E Carroll St, Salisbury, MD 21801-5493 | 2016-06-24 |
1407199706 | William Ennis Jr. | Physician Assistant | 6507 Deer Pointe Dr, Salisbury, MD 21804-1667 | 2013-04-04 |
1154560449 | Timothy Ryan Schenk | Physician Assistant | 605 Grove St, Salisbury, NC 28144-3233 | 2009-02-11 |
1588628721 | James Kris Watson | Physician Assistant | 320 Jake Alexander Blvd W, Suite 103, Salisbury, NC 28147-1442 | 2006-04-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205475803 | Kendy Karenys Lopez | Physician Assistant | 18324 Streamside Dr Apt 204, Gaithersburg, MD 20879-5228 | 2019-12-30 |
1528619640 | Cindy Pham | Physician Assistant | 7515 Oyster Bay Way, Gaithersburg, MD 20886-5905 | 2019-09-20 |
1508336637 | Victor Orlando Hernandez | Physician Assistant | 125 Potomac Psge Unit 200, Oxon Hill, MD 20745-1580 | 2018-12-02 |
1164905824 | Surgical Focus LLC | Physician Assistant | 5550 Friendship Blvd Ste 100, Chevy Chase, MD 20815-7294 | 2018-09-10 |
1912497173 | Gem Y Walker Lawson | Physician Assistant | 6500 Rock Spring Dr Ste 100, Bethesda, MD 20817-1182 | 2018-05-14 |
1306341540 | Sunil Harris | Physician Assistant | 22 S. Green St, University of Maryland Medical Center, Baltimore, MD 21201-1595 | 2018-03-29 |
1134639263 | Liz Ramirez | Physician Assistant | 1101 E 33rd St, Baltimore, MD 21218-3637 | 2017-10-03 |
1093231755 | Daniel Gentry | Physician Assistant | 301 Saint Paul St Ste Pob 802, Baltimore, MD 21202-2102 | 2017-08-15 |
1467981431 | Lana E Grubb | Physician Assistant | 12502 Willowbrook Rd Ste 470, Cumberland, MD 21502-6593 | 2017-06-05 |
1174051353 | Nam Anh Pham | Physician Assistant | 227 Saint Paul St Fl 6, Baltimore, MD 21202-2001 | 2017-05-31 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.