MR. LEONARD WILLIAM RUSSO PA-C NPI 1902905979

NPI Information

NPI: 1902905979
Provider Name: MR. LEONARD WILLIAM RUSSO, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
22255 GREENFIELD RD
SOUTHFIELD, MI
ZIP 48075
Phone: (248) 849-3066
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MR. Leonard William Russo, PA-C is a medical physician assistant in Southfield, MI. MR. Leonard William Russo, PA-C NPI is 1902905979. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

22255 GREENFIELD RD
SOUTHFIELD, MI
ZIP 48075-710
Phone: (248) 849-3066

The enumeration date for this NPI number is 9/22/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	5601001728	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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