Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Lorenzo Joseph-Gerard Russo, MD

Individual provider Family Medicine Physician · NPI 1336843747

Dr. Lorenzo Joseph-Gerard Russo, MD is a Family Practice in Clinton Township, Michigan. Qualified in 2023, 3 years ago. Practices as a sole proprietor. Licensed in Michigan.

Years since qualifying
3
Licensed in
MI
In the registry since
2023
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone: (586) 263-2971
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 4301513734 (MI)

Record details

NPI number1336843747
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 29, 2023
Last updated in NPPESFebruary 12, 2025
Certification dateFebruary 12, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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