National Provider Identifier Database

TRINA M RUSSO, DPM – NPI #1174500862
Podiatrist

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 and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.


Contact Information

TRINA M RUSSO, DPM
20967 KELLY RD
EASTPOINTE, MI48021
Phone: 586-779-8600
Fax: 586-779-2019
Website:
Specialty Taxonomy Code
* Podiatrist 213E00000X

* Indicates primary specialty

NPI Profile & details for TRINA M RUSSO

NPI Number 1174500862
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 12/23/2005
Last updated 12/29/2016 - About 9 years ago
Sole proprietor1 Yes
Identifiers
  • MI License #: TR001571
  • MI Medicaid: 2760454
  • Other: 5505057 BS MI
  • MI Other: 480E020980 BS MICH
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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