Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 25MA03213400 | NJ |
NPI | 1255540159 |
---|---|
Provider Name | Dr. Richard Douglas Ross |
First Address | Philadelphia, PA 19103-4804 |
Second Address | Philadelphia, PA 19103-4804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 08/07/2007 |