Healthcare Provider Details

I. General information

NPI: 1811375041
Provider Name (Legal Business Name): ADAM MICHAEL ROSS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2015
Last Update Date: 07/30/2021
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3126 N CIVIC CENTER PLZ
SCOTTSDALE AZ
85251-6912
US

IV. Provider business mailing address

3126 N CIVIC CENTER PLZ
SCOTTSDALE AZ
85251-6912
US

V. Phone/Fax

Practice location:
  • Phone: 480-874-2040
  • Fax: 480-874-2041
Mailing address:
  • Phone: 480-874-2040
  • Fax: 480-874-2041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number63943
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: