Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 27171 | VA |
NPI | 1073526430 |
---|---|
Provider Name | Dr. Peter Stephen Ross |
First Address | Fairfax, VA 22033-1710 |
Second Address | Fairfax, VA 22033-1710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 08/07/2007 |