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General NPI Number Information
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NPI Number | 1265725493
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Entity Type | Individual
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Provider Name | ROSS FELLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/20/2011
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Last Update Date | 12/22/2022
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Provider Practice Location Address
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Address Line | MMP ORTHOPEDICS AND SPORTS MEDICINE 119 GANNET DRIVE
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106
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Country | US
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Telephone | 207-773-0040
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Fax |
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Provider Business Mailing Address
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Address Line | MMP ORTHOPEDICS AND SPORTS MEDICINE 119 GANNET DRIVE
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106
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Country | US
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Telephone | 207-773-0040
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Fax |
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD15421
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 10320669-1205
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | 10320669-1205
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 10320669-1205
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License Number State | UT
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Taxonomy #5
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD22336
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License Number State | ME
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