Individual
MR. DOUGLAS JAY ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
351 EDWIN DRIVE, SUITE 102, VIRGINIA BEACH, VA 23462
(757) 499-5550
(757) 473-0919
Mailing address
860 OMNI BLVD, SUITE 303, NEWPORT NEWS, VA 23606
(757) 232-8777
(757) 232-8866
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110840456
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255329900
—
VA
Enumeration date
10/07/2005
Last updated
05/24/2012
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