Individual
MICHELLE A ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1412 MILSTEAD AVE NE, CONYERS, GA 30012-3877
(770) 918-3000
Mailing address
PO BOX 200096, CARTERSVILLE, GA 30120-9002
(678) 905-7053
(678) 905-7053
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
045603
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000826856A
—
GA
Enumeration date
01/06/2006
Last updated
01/09/2019
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