Individual
ABIGAIL MADISON ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5401 N BROAD ST, PHILADELPHIA, PA 19141
(215) 456-8220
Mailing address
5401 N BROAD ST, PHILADELPHIA, PA 19141
(215) 456-7890
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA064163
PA
Other
Enumeration date
02/16/2023
Last updated
05/20/2023
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