Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 2019-00014 | NC |
NPI | 1114285350 |
---|---|
Provider Name | Malcolm Strachan Ross |
First Address | Charlotte, NC 28260-0447 |
Second Address | Charlotte, NC 28204-3215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2012 |
Last Update Date | 19/08/2021 |