Healthcare Provider Details

I. General information

NPI: 1861923286
Provider Name (Legal Business Name): MINER NOAH ROSS M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL DR
COLUMBIA MO
65212-0001
US

IV. Provider business mailing address

PO BOX 843966
KANSAS CITY MO
64184-3966
US

V. Phone/Fax

Practice location:
  • Phone: 573-882-4908
  • Fax: 573-884-5184
Mailing address:
  • Phone: 573-884-3300
  • Fax: 573-884-0934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number82947
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number2025037618
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: