Healthcare Provider Details

I. General information

NPI: 1538176730
Provider Name (Legal Business Name): JAMES W ROSS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 03/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4175 N HANSON CT STE 100
BOWIE MD
20716-3179
US

IV. Provider business mailing address

106 IRVING ST NW STE 2700N
WASHINGTON DC
20010-2927
US

V. Phone/Fax

Practice location:
  • Phone: 301-809-6880
  • Fax: 301-805-4233
Mailing address:
  • Phone: 202-723-5524
  • Fax: 202-291-0512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD23148
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: