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Contact Information

TRINA M RUSSO, DPM
20967 KELLY RD
EASTPOINTE, MI48021
 Phone: 586-779-8600
 Fax: 586-779-2019
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for TRINA M RUSSO · (Female)

NPI Number 1174500862
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 12/23/2005
Last updated 12/29/2016 - About 9 years ago
Sole proprietor 1 Yes
Identifiers
  • MI License # TR001571
  • MI Medicaid 2760454
  • Other 5505057 BS MI
  • MI Other 480E020980 BS MICH
Hospital affiliation(s) Not Available
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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