MEDICARE: DR. JUDY D ROSS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MD417419	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245226315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDY D ROSS MD

Provider Business Mailing Address
First Line	:	1050 BOWER HILL RD
Second Line	:	205
City	:	PITTSBURGH
State	:	PA
Zip	:	15243-1800
Country	:	US
Telephone Number	:	412-572-6184
Fax Number	:	412-572-6586

Provider Business Practice Location Address
First Line	:	1050 BOWER HILL RD
Second Line	:	205
City	:	PITTSBURGH
State	:	PA
Zip	:	15243-1800
Country	:	US
Telephone Number	:	412-572-6184
Fax Number	:	412-572-6586

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	12/15/2011

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