MEDICARE: DR. LOUIS A. 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
1	2084P0800X	Psychiatry Physician	DC16291	DC

General Provider Information

NPI Number	:	1790849677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS A. ROSS M.D.

Provider Business Mailing Address
First Line	:	1312 18TH ST NW
Second Line	:	#302
City	:	WASHINGTON
State	:	DC
Zip	:	20036-1808
Country	:	US
Telephone Number	:	202-290-3115
Fax Number	:

Provider Business Practice Location Address
First Line	:	1312 18TH ST NW
Second Line	:	#302
City	:	WASHINGTON
State	:	DC
Zip	:	20036-1808
Country	:	US
Telephone Number	:	202-290-3115
Fax Number	:

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

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	03/07/2008

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