Individual
DR. JEROME ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D0009835
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018041600
—
MD
01
—
36069
MAMSI
MD
01
—
452862
AETNA
MD
01
—
5322-0001
BLUE CHOICE
MD
Enumeration date
06/21/2005
Last updated
05/05/2011
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