Healthcare Provider Details

I. General information

NPI: 1043409451
Provider Name (Legal Business Name): STEVEN EDWARD ROSS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2007
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 POND ST
SHARON MA
02067-2037
US

IV. Provider business mailing address

8 REGATTA DR
MASHPEE MA
02649-2545
US

V. Phone/Fax

Practice location:
  • Phone: 781-784-6767
  • Fax:
Mailing address:
  • Phone: 774-284-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number38736
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: