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

MS. Susan Marie Russo

Individual provider Family Medicine Physician · NPI 1629714936

MS. Susan Marie Russo is a Nurse Practitioner in Sterling Heights, Michigan. Graduated from Univ of Western Ontario Schulich School of Med in 2021, 5 years ago. Works from 2 locations. Licensed in Michigan.

Years since qualifying
5
Trained at
Univ of Western Ontario Schulich School of Med
Licensed in
MI
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

14500 Hall Rd
Sterling Heights, MI 48313-1229
Phone: (800) 653-6568
Fax: (313) 876-1305
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1403 Sugarwood Cres, Lasalle, 924 — (519) 967-8546

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4704189539 (MI)
Family Medicine Physician Taxonomy 207Q00000X · Licence 4704189539 (MI)

Record details

NPI number1629714936
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 10, 2022
Last updated in NPPESDecember 20, 2022
Certification dateDecember 20, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIV OF WESTERN ONTARIO SCHULICH SCHOOL OF MED
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

Other providers in Sterling Heights