Dr Samuel J Russo, DO is a
Family Medicine physician based in Elmira, Michigan. Dr Samuel J Russo is licensed to practice in Michigan (license number 5101008981) and his current practice location is 2572 N Us Highway 131, Elmira, Michigan. He can be reached at his office (for appointments etc.) via phone at
(989) 731-7700.
NPI number for Dr Samuel J Russo is 1962510636 and his current mailing address is 829 N Center Ave, Suite 298, Gaylord, Michigan. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1962510636.
Physician's Profile
| Full Name | Dr Samuel J Russo |
|---|
| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 2572 N Us Highway 131, Elmira, Michigan |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1962510636
- Provider Enumeration Date: 08/25/2006
- Last Update Date: 12/03/2013
Medical Identifiers
Medical identifiers for Dr Samuel J Russo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962510636 | NPI | - | NPPES |
| OF96004 | Other | | GROUP MEDICARE ID |
| 500400122 | Medicaid | OR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | DO15969 (Oregon) | Secondary |
| 207Q00000X | Family Medicine | 5101008981 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Samuel J Russo is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Samuel J Russo, DO
829 N Center Ave, Suite 298,
Gaylord, MI 49735-1595
Ph: (989) 731-7708 | Dr Samuel J Russo, DO
2572 N Us Highway 131,
Elmira, MI 49730-8252
Ph: (989) 731-7700 |
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