Russo, Anthony R

Russo, Anthony R is an individual health care provider with primary practice located at 1326 E Little Creek Rd , Norfolk VA 23518. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Russo, Anthony R can be contacted via phone (757) 583-6338.

Contact Information

Primary practice address
1326 E Little Creek Rd Norfolk VA 23518
Phone: (757) 583-6338
Fax: (757) 531-9410
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101045049 Virginia

Profile Details

NPI number 1427023720
LBN Legal business name Russo, Anthony R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2006
Last updated Oct 26th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427023720 NPPES
Virginia MEDICAID 005619424

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