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NPI Code Detail

MEDICARE: MS. RACHAEL L ROSS MD

MEDICARE: MS. RACHAEL L 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
1207Q00000XFamily Medicine Physician01057346AIN
2207P00000XEmergency Medicine Physician01057346AIN

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 : 1467447755
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RACHAEL L ROSS MD
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 :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2005
Last Update Date : 02/23/2017

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Directions to “ MS. RACHAEL L ROSS MD” Practice Location

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