Individual
RUSTIN RONALD ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
389 S 900 E, SALT LAKE CITY, UT 84102
(385) 282-2000
(385) 282-2001
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(385) 282-2000
(385) 282-2001
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
373233-1205
UT
Other
Enumeration date
05/22/2007
Last updated
12/05/2012
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