Trina Mary Russo in Clinton Township - Podiatrist
Trina Mary Russo - NPI 1174500862
Trina Mary Russo is a Podiatrist in Clinton Township, Michigan. Trina Mary Russo practices all healthcare services and medical treatments related to Podiatrist. The NPI Number for Trina Mary Russo is 1174500862. The last update date is 2016-12-29.
Trina Mary Russo's current location address is 39090 Garfield Rd, Clinton Township, Michigan. You can contact this provider via phone number 5867798600 and fax number 5867792019. The mailing address for Trina Mary Russo is 39090 Garfield Rd, Clinton Township, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Trina Mary Russo |
|---|---|
| Address | 39090 Garfield Rd, Clinton Township, Michigan |
| Phone Number | 5867798600 |
| Fax Number | 5867792019 |
| Sole Proprietor | Y |
| Credentials | DPM |
NPI Number Detail
| NPI Number | 1174500862 |
|---|---|
| Provider Enumeration Date | 2005-12-23 |
| Last Updated Date | 2016-12-29 |
Provider Mailing Address Detail
| Address | 39090 Garfield Rd |
|---|---|
| City | Clinton Township |
| State | Michigan (MI) |
| Post Code | 480384093 |
| Phone Number | 5867798600 |
| Fax Number | 5867792019 |
Provider's Primary Taxonomy Detail
| Speciality | Podiatrist |
|---|---|
| Taxonomy | 213E00000X |
| Licence No | TR001571 |
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Definition: A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2760454 | MI | -- | |
| 480E020980 | MI | BS MICH | |
| 5505057 | BS MI |
Post Comment/ Review Below
What is the Trina Mary Russo's 1174500862?
The Trina Mary Russo's NPI (National Provider Identifier) Number is 1174500862. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Trina Mary Russo is physically located?
The Trina Mary Russo is situated at the following address: 39090 Garfield Rd, Clinton Township, MI 480384093.
What is Trina Mary Russo's specialized field of practice, and what is the corresponding taxonomy classification code?
The Trina Mary Russo's area of specialization is Podiatrist, and the corresponding taxonomy code that categorizes this field of practice is 213E00000X.
On what date did the Trina Mary Russo receive the assignment of its 1174500862 from the Centers for Medicare & Medicaid Services?
The Trina Mary Russo was issued its 1174500862 by the Centers for Medicare & Medicaid Services on 2005-12-23.
When was the information related to Trina Mary Russo most recently updated or refreshed?
The details pertaining to the Trina Mary Russo, including its address, specialty, and other relevant information, were last updated or refreshed on 2016-12-29.