Healthcare Provider Details

I. General information

NPI: 1992916704
Provider Name (Legal Business Name): ROSS MICHAEL GERMANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 04/30/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DOCTORS DR
GREENVILLE SC
29605-4266
US

IV. Provider business mailing address

1 DOCTORS DR
GREENVILLE SC
29605-4266
US

V. Phone/Fax

Practice location:
  • Phone: 864-572-7001
  • Fax: 864-412-0436
Mailing address:
  • Phone: 864-572-7001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number51320
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: