Martin T Russo Jr, DO | |
1310 Wisconsin Ave Ste 103, Grand Haven, MI 49417 | |
(616) 846-2640 | |
(616) 846-3110 |
Full Name | Martin T Russo Jr |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 46 Years |
Location | 1310 Wisconsin Ave Ste 103, Grand Haven, Michigan |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508876236 | NPI | - | NPPES |
4094275 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 5101014183 (Michigan) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Mercy Physician Network | 8921996307 | 98 |
Entity Name | Mercy Physician Network |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023056744 PECOS PAC ID: 8921996307 Enrollment ID: O20040308000687 |
Entity Name | Noch Physician Billing Company Llc |
---|---|
Entity Type | Part B Supplier - Hospital Department(s) |
Entity Identifiers | NPI Number: 1972550580 PECOS PAC ID: 8527078583 Enrollment ID: O20140401000168 |
Mailing Address | Practice Location Address |
---|---|
Martin T Russo Jr, DO 1310 Wisconsin Ave, Ste 101, Grand Haven, MI 49417-2472 Ph: (616) 847-5604 | Martin T Russo Jr, DO 1310 Wisconsin Ave Ste 103, Grand Haven, MI 49417 Ph: (616) 846-2640 |
Lee Michael Sterenberg, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 600 Park Ave, Grand Haven, MI 49417 Phone: 616-847-8700 Fax: 616-847-1049 | |
Shawn Patrick Reidy, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1445 Sheldon Rd, Ste 300, Grand Haven, MI 49417 Phone: 616-296-1500 Fax: 616-296-1502 | |
Christopher Jase Rogalla, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 15100 Whittaker Way, Grand Haven, MI 49417 Phone: 616-935-6320 Fax: 616-935-6325 | |
Larry A Poel, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1310 Wisconsin Ave, Suite 301, Grand Haven, MI 49417 Phone: 616-847-1860 Fax: 616-844-4670 | |
Stanley Haegert, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1310 Wisconsin St, Suite 103, Grand Haven, MI 49417 Phone: 616-846-2640 Fax: 616-846-3110 | |
Bradley A Martino, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1091 S Beacon Blvd, Grand Haven, MI 49417 Phone: 616-604-0096 Fax: 616-604-0095 | |
Dr. Kyle Lee Snell, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 15100 Whittaker Way, Grand Haven, MI 49417 Phone: 616-935-6320 |