Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD023752E | PA |
NPI | 1003840505 |
---|---|
Provider Name | Dr. Michael Paul Russo |
First Address | York, PA 17402-9001 |
Second Address | York, PA 17406-8083 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 22/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000985796 | (05) | PA |
0068412000 | AMERIHEALTH 65 PA (01) | PA |
03124601 | CAPITAL BLUE CROSS-WMG (01) | PA |
032661 | JOHNS HOPKINS (01) | PA |
053883300 | (05) | MD |
086178 | HIGHMARK BLUE SHIELD (01) | PA |
1142793 | AMERIHEALTH MERCY-WMG (01) | PA |
1517480 | GATEWAY-WMG (01) | PA |
20072397 | AMERIHEALTH MERCY-YHOBGYN (01) | PA |
30115669 | AMERIHEALTH MERCY - WMG (01) | PA |
30120490 | AMERIHEALTH MERCY - YH (01) | PA |
348556 | MAMSI-WMG (01) | PA |
36693 | GEISINGER (01) | PA |
4545155 | AETNA (01) | PA |
524955 | CAREFIRST MD BCBS (01) | MD |
81659 | UNISON-WMG (01) | PA |
C29397 | (02) |