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NPI Code Detail

MEDICARE: DR. MARY ELIZABETH ROSS M.D.

MEDICARE: DR. MARY ELIZABETH ROSS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD 33952SC
2208000000XPediatrics PhysicianMD 33952SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346446499
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY ELIZABETH ROSS M.D.
Provider Business Mailing Address
First Line : 217 HARBOURREEF DR
Second Line :
City : PAWLEYS ISLAND
State : SC
Zip : 29585-5799
Country : US
Telephone Number : 843-314-9018
Fax Number :
Provider Business Practice Location Address
First Line : 64 BUSINESS CENTER DR
Second Line :
City : PAWLEYS ISLAND
State : SC
Zip : 29585-7963
Country : US
Telephone Number : 843-313-1314
Fax Number : 843-314-1308
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2007
Last Update Date : 12/10/2012

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