# ROSS SAMUEL OLIVER JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1053497453
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 13925 | WV | Yes |

## Other

- **Enumeration date:** 10/27/2006
- **Last updated:** 05/14/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 001721031 | BC BS | WV |
| 05 | — | 0130039000 | — | WV |
| 01 | — | 0216253040000 | TRICARE | WV |
| 01 | — | 1002718509 | ACORDIA PEIA | WV |
| 01 | — | 1393063 | MC UMW | WV |
| 01 | — | 1508836 | CIGNA | WV |
| 01 | — | 185112 | SELECT NET | WV |
| 01 | — | 221960 | CARELINK | WV |
| 01 | — | 340002703 | RAILROAD MC | WV |
| 01 | — | 4242731 | AETNA | WV |