| Martin T Russo Jr, DO | |
|
1310 Wisconsin Ave Ste 103, Grand Haven, MI 49417 | |
| (616) 846-2640 | |
| (616) 846-3110 |
| Full Name | Martin T Russo Jr |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 48 Years |
| Location | 1310 Wisconsin Ave Ste 103, Grand Haven, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508876236 | NPI | - | NPPES |
| 4094275 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5101014183 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mercy Health Hackley Campus | Muskegon, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mercy Physician Network | 8921996307 | 110 |
| Entity Name | Mercy Physician Network |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023056744 PECOS PAC ID: 8921996307 Enrollment ID: O20040308000687 |
| Entity Name | Noch Physician Billing Company Llc |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1972550580 PECOS PAC ID: 8527078583 Enrollment ID: O20140401000168 |
| Mailing Address | Practice Location Address |
|---|---|
| Martin T Russo Jr, DO 1310 Wisconsin Ave, Ste 101, Grand Haven, MI 49417-2472 Ph: (616) 847-5604 | Martin T Russo Jr, DO 1310 Wisconsin Ave Ste 103, Grand Haven, MI 49417 Ph: (616) 846-2640 |
Lee Michael Sterenberg, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 600 Park Ave, Grand Haven, MI 49417 Phone: 616-847-8700 Fax: 616-847-1049 | |
Shawn Patrick Reidy, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1445 Sheldon Rd, Ste 300, Grand Haven, MI 49417 Phone: 616-296-1500 Fax: 616-296-1502 | |
Christopher Jase Rogalla, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 15100 Whittaker Way, Grand Haven, MI 49417 Phone: 616-935-6320 Fax: 616-935-6325 | |
Shelley Ostric, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 326 N. Ferry St., Grand Haven, MI 49417 Phone: 616-846-2701 Fax: 616-846-8009 | |
Larry A Poel, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1310 Wisconsin Ave, Suite 301, Grand Haven, MI 49417 Phone: 616-847-1860 Fax: 616-844-4670 | |
Stanley Haegert, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1310 Wisconsin St, Suite 103, Grand Haven, MI 49417 Phone: 616-846-2640 Fax: 616-846-3110 | |
Kristina Powell, Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 1445 Sheldon Rd Ste 300, Grand Haven, MI 49417 Phone: 616-296-1500 Fax: 616-296-1502 |