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NPI Code Detail

MEDICARE: DR. MARK J ROSS M.D.

MEDICARE: DR. MARK J ROSS M.D.
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
1207W00000XOphthalmology Physician11764SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
7180012103OTHERSCRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14254796OTHERSCAETNA
29624212OTHERSCGHI
3276873OTHERSCPRIVATE HEALTHCARE SYSTEM
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5621812OTHERSCSELECT HEALTH
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8S327574OTHERSCCIGNA

General Provider Information

NPI Number : 1508869090
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK J ROSS M.D.
Provider Business Mailing Address
First Line : 367 W EVANS ST
Second Line :
City : FLORENCE
State : SC
Zip : 29501-3429
Country : US
Telephone Number : 843-669-4156
Fax Number : 843-664-2121
Provider Business Practice Location Address
First Line : 367 W EVANS ST
Second Line :
City : FLORENCE
State : SC
Zip : 29501-3429
Country : US
Telephone Number : 843-669-4156
Fax Number : 843-664-2121
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 02/14/2024

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Directions to “ DR. MARK J ROSS M.D.” Practice Location

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