Healthcare Provider Details

I. General information

NPI: 1649276387
Provider Name (Legal Business Name): WILLIAM M ROSS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 08/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 KUSER RD
HAMILTON NJ
08691-3302
US

IV. Provider business mailing address

3625 QUAKERBRIDGE RD
HAMILTON NJ
08619-1207
US

V. Phone/Fax

Practice location:
  • Phone: 609-585-8800
  • Fax: 609-585-1825
Mailing address:
  • Phone: 609-689-1600
  • Fax: 609-689-1200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMA05183900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD031213-E
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMA05183900
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMD031213E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: