MEDICARE: SUSAN DONNA ROSS- WEBB 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
1	2084P0800X	Psychiatry Physician	01428	NC

Other Identifiers

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

General Provider Information

NPI Number	:	1457374597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN DONNA ROSS- WEBB M.D.

Provider Business Mailing Address
First Line	:	200 N GREENSBORO ST STE D7
Second Line	:
City	:	CARRBORO
State	:	NC
Zip	:	27510-1833
Country	:	US
Telephone Number	:	919-448-4498
Fax Number	:	919-929-3952

Provider Business Practice Location Address
First Line	:	200 N GREENSBORO ST STE D7
Second Line	:
City	:	CARRBORO
State	:	NC
Zip	:	27510-1833
Country	:	US
Telephone Number	:	919-448-4498
Fax Number	:	919-929-3952

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	12/28/2012

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