Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 24873 | NC |
NPI | 1013181270 |
---|---|
Provider Name | Dr. Robert Mitchell Ross |
First Address | High Point, NC 27262-7254 |
Second Address | Winston Salem, NC 27103-2973 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2008 |
Last Update Date | 24/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
890126Y | (05) | NC |
8973372 | (05) | NC |
C81258 | (02) | NC |