Michael B. Russo MD INC

NPI #1477806214 in Honolulu, Hawaii

Provider Information

NPI Number
1477806214
Entity Type
Organization
Organization Name
Michael B. Russo MD INC
Subpart
Yes (part of a larger organization)
Parent Organization
MICHAEL B. RUSSO MD INC
Primary Specialty
Non-Pharmacy Dispensing Site
Enumeration Date
Oct 17, 2012
Last Updated
Oct 26, 2015

Practice Location

Address
320 WARD AVE
Address 2
SUITE 101
State
Hawaii
ZIP Code
96814-4001
Phone
(808) 294-3332

Authorized Official

Name
DR. MICHAEL B. RUSSO, MD
Title
OWNER
Phone
(808) 294-3332

Specialties & Taxonomy Codes

Specialty
Non-Pharmacy Dispensing Site

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