Individual
MITCHELL K ROSS
Active
Individual
MITCHELL K ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
MD12092
ME
2084N0400X
Neurology Physician
Primary
12092
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432007500
—
ME
Enumeration date
10/25/2005
Last updated
03/20/2013
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