Healthcare Provider Details

I. General information

NPI: 1629277710
Provider Name (Legal Business Name): ANA P ROSSI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 07/08/2020
Certification Date: 07/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1968 PEACHTREE ROAD NE BLD 77 5TH FLOOR
ATLANTA GA
30309
US

IV. Provider business mailing address

1600B CONGRESS ST
PORTLAND ME
04102-2124
US

V. Phone/Fax

Practice location:
  • Phone: 404-605-4600
  • Fax:
Mailing address:
  • Phone: 207-774-5222
  • Fax: 207-761-4433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD18623
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberEC071061
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD18623
License Number StateME
# 4
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number85718
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: