Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Martin T Russo Jr., DO

Individual provider Family Medicine Physician · NPI 1508876236

Martin T Russo Jr., DO is a Family Practice in Grand Haven, Michigan. Graduated from Midwestern University, Chicago College of Osteopathic Med in 1978, 48 years ago. Practices with Mercy Physician Network, a 110-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
48
Trained at
Midwestern University, Chicago College of Osteopathic Med
Licensed in
MI
In the registry since
2006
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1310 Wisconsin Ave Ste 103
Grand Haven, MI 49417
Phone: (616) 846-2640
Fax: (616) 846-3110
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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 5101014183 (MI)

Record details

NPI number1508876236
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedAugust 8, 2006
Last updated in NPPESJune 11, 2018

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolMIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Graduated 1978 (48 years in practice)
Group practice Mercy Physician Network — 110 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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