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NPI Code Detail

MEDICARE: DAVID E ROSS, JR, MD,PC

MEDICARE: DAVID E ROSS, JR, MD,PC
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
1207Q00000XFamily Medicine Physician

Other Identifiers

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

General Provider Information

NPI Number : 1407985971
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVID E ROSS, JR, MD,PC
Provider Business Mailing Address
First Line : PO BOX 4787
Second Line :
City : GARY
State : IN
Zip : 46404-0787
Country : US
Telephone Number : 219-886-4788
Fax Number : 219-886-4106
Provider Business Practice Location Address
First Line : 1619 W 5TH AVE
Second Line :
City : GARY
State : IN
Zip : 46404-1506
Country : US
Telephone Number : 219-886-4788
Fax Number : 219-886-4106
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. NATHANIEL ROSS I
Credential : M.D.
Telephone Number : 219-886-4788
Provider Enumeration Date : 03/02/2007
Last Update Date : 05/17/2024

Similar Medicare Providers

1417942707 — MR. NATHANIEL T ROSS MD
Practice Location Address:
1619 W 5TH AVE
GARY, IN
46404-1506
Practice Phone: 219-886-4788
Practice Fax: 219-886-4106
1467447755 — MS. RACHAEL L ROSS MD
Practice Location Address:
1619 W 5TH AVE
GARY, IN
46404-1506
Practice Phone: 219-886-4788
Practice Fax: 219-886-4106
1710171707 — MS. LOLITA IZETT HARMON FNP-BC
Practice Location Address:
1619 W 5TH AVE
GARY, IN
46404-1506
Practice Phone: 219-886-4788
Practice Fax: 219-886-4106
1346486842 — EDWARD B ZIESMER PT MS
Practice Location Address:
1619 W 5TH AVE
GARY, IN
46404-1506
Practice Phone: 219-886-4788
Practice Fax:
1396136511 — 5TH AVE DENTAL INC.
Practice Location Address:
1619 W 5TH AVE
GARY, IN
46404-1506
Practice Phone: 708-359-2068
Practice Fax:
1891586137 — AALIYAH CHLOE HARMON APRN (FNP-C)
Practice Location Address:
1619 W 5TH AVE
GARY, IN
46404-1506
Practice Phone: 219-886-4788
Practice Fax: 219-886-4106

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