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General NPI Number Information
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NPI Number | 1194712208
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Entity Type | Individual
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Provider Name | JONATHAN ROSS M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 04/14/2021
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Provider Practice Location Address
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Address Line | 6410 ROCKLEDGE DR STE 610
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City | BETHESDA
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State | MD
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Zip | 20817-1844
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Country | US
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Telephone | 301-530-9745
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Fax | 301-530-0046
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Provider Business Mailing Address
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Address Line | 6410 ROCKLEDGE DR STE 610
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City | BETHESDA
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State | MD
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Zip | 20817-1844
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Country | US
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Telephone | 301-530-9745
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Fax | 301-530-0046
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 10401
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | D83244
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 79897
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 79897
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 10401
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License Number State | NH
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